Individual provider Active NPI

Monali Patel, OD

  • Optometrist
  • Pooler, GA
National Provider Identifier
1730685439
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003072 Issued in GA
Practice address
276 Pooler Pkwy Ste B
Pooler, GA 31322
Phone
(912) 330-8884
NPI assigned
Apr 2, 2018
Last updated
May 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003072 GA Primary

Addresses

Primary practice location

276 Pooler Pkwy Ste B
Pooler, GA 31322

Mailing address

111 W Pine St
Jesup, GA 31545-1338
Phone (912) 424-1138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180716003452 GA Practitioner - Optometry 7113274598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003072GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince May 16, 2018 Accepting new patients
Mark Lynn O.D. & Associates, PC CurrentSince May 16, 2018 Accepting new patients

Locations

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

276 Pooler Pkwy
Ste B
Pooler, GA 31322
Phone (912) 330-8884

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1730685439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W PINE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451338",
            "telephone_number": "912-424-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 POOLER PKWY STE B",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "31322",
            "telephone_number": "912-330-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MONALI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.