Individual provider Active NPI

Reena Mehta, OD

  • Optometrist
  • West Columbia, SC
National Provider Identifier
1710919147
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1993 Issued in SC
Practice address
103 Saluda Ridge CT
West Columbia, SC 29169
Phone
(803) 434-2020
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5357/T2265 OH
Optometrist 152W00000X 1993 SC Primary

Addresses

Primary practice location

103 Saluda Ridge CT
West Columbia, SC 29169

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

508 Fulton St
Durham, NC 27705-3875
Phone (919) 286-0411 ext. 6364

Other identifiers 1

IdentifierTypeStateIssuer
D19336MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180103003323 SC Practitioner - Optometry 5890053474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

103 Saluda Ridge CT
West Columbia, SC 29169-3455
Phone (803) 794-3320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5357/T2265OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Optometrist CurrentSince Dec 16, 2019 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 16, 2019 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

4 Medical Park Rd
Columbia, SC 29203
Phone (803) 434-2020

103 Saluda Ridge Ct
West Columbia, SC 29169
Phone (803) 794-3320

Interoperability endpoints

  • Direct secure messaging: rmehta382244@direct.ghs.myhfn.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1710919147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SALUDA RIDGE CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "803-434-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 Fulton St",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277053875",
            "country_code": "US",
            "telephone_number": "919-286-0411 x6364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "REENA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5357/T2265",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D19336",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.