Raleigh Eye and Face Plastic Surgery PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RALEIGH EYE AND FACE PLASTIC SURGERY PLLC

Practice address

4201 Lake Boone TRL Ste 103
Raleigh, NC 27607-7511

Phone

(919) 626-8783

Fax

(844) 456-0925

NPI assigned

Oct 1, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Pradeep Mettu, MDNPI 1215236419

Title

Owner/Member

Phone

(919) 626-8783

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pradeep Mettu, M.D.

  • Ophthalmology Physician
  • Raleigh, NC
  • NPI 1215236419
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570233600000",
    "number": "1720629637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "919-626-8783",
            "fax_number": "844-456-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "919-626-8783",
            "fax_number": "844-456-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH EYE AND FACE PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-05",
        "status": "A",
        "authorized_official_last_name": "METTU",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "919-626-8783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Raleigh Emergency Surgical, Inc
• Raleigh Employee Assistance Program
• Raleigh Express Transportation LLC
• Raleigh Eye Center, PA
• Raleigh Family and Injury Chiropractic
• Raleigh Family Health Care
• Raleigh Family Practice PA
• Raleigh Family Practice, P.a.

• Ophthalmology Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.