Active NPI
Monali Patel, OD
- Optometrist
- Pooler, GA
National Provider Identifier
1730685439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT003072
- Practice address
- 276 Pooler Pkwy Ste B
Pooler, GA 31322 - Phone
- (912) 330-8884
- NPI assigned
- Apr 2, 2018
- Last updated
- May 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT003072 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Lynn OD & Associates, PC | Optometrist | Current | Accepting new patients |
| Mark Lynn O.D. & Associates, PC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.