Individual provider Active NPI

Thomas C McIntosh, O.D.

  • Optometrist
  • Greenville, NC
National Provider Identifier
1750352688
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1195 Issued in NC
Practice address
1804 W Arlington Blvd
Greenville, NC 27834-5704
Phone
(252) 752-4380
Fax
(252) 747-0419
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1195 NC Primary

Addresses

Primary practice location

1804 W Arlington Blvd
Greenville, NC 27834-5704

Mailing address

1804 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 752-4380

Other identifiers 4

IdentifierTypeStateIssuer
7909578MedicaidNC
09578OtherNCBCBS
1679675581OtherNCGROUP NPI
410017944OtherNCMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090922000369 NC Practitioner - Optometry 4183720329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Vision Care Dr. Thomas C. McIntosh OD PAGroup PAC ID 7113023359, 3 clinicians
Carolina Vision Care DRS. McIntosh and Associates OD PAGroup PAC ID 4688087745, 3 clinicians

Practice addresses (Care Compare)

1804 W Arlington Blvd
Greenville, NC 27834-5704
Phone (252) 752-4380

915 E Fire Tower Rd
Suite 108
Winterville, NC 28590-9303
Phone (252) 516-6581

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC1195NCMDOptometrist
1195NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Vision Care DRS. McIntosh & Associates OD PA Optometrist CurrentSince Sep 1, 2020 Accepting new patients
Carolina Vision Care Dr. Thomas C. McIntosh OD PA Optometrist CurrentSince Jun 1, 1994 Accepting new patients

Locations

1804 W Arlington Blvd
Greenville, NC 27834
Phone (252) 752-4380

915 E Fire Tower Rd
Ste 108
Winterville, NC 28590
Phone (252) 516-6581

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1750352688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-752-4380",
            "fax_number": "252-747-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 W ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345704",
            "telephone_number": "252-752-4380",
            "fax_number": "252-747-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909578",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09578",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1679675581",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410017944",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.