Individual provider Active NPI

Matthew Wade Bickford, MD

  • Ophthalmology Physician
  • Boiling Springs, SC
National Provider Identifier
1750841383
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
LL82611 Issued in SC
Practice address
1520 Boiling Springs Rd
Boiling Springs, SC 29316-5121
Phone
(864) 505-6060
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X LL82611 SC Primary

Addresses

Primary practice location

1520 Boiling Springs Rd
Boiling Springs, SC 29316-5121

Mailing address

1520 Boiling Springs Rd
Boiling Springs, SC 29316-5121
Phone (864) 505-6060

Other practice location 1

9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone (843) 876-7080

Other practice location 2

9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone (843) 876-7080

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423003267 SC Practitioner - Ophthalmology 9638409329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical University of South Carolina College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Eye and Laser Center LLCGroup PAC ID 1850317819, 6 clinicians

Practice addresses (Care Compare)

1520 Boiling Springs Rd
Boiling Springs, SC 29316-5121
Phone (864) 583-6381

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Eye & Laser Center, LLC Ophthalmology CurrentSince May 1, 2024 Accepting new patients
Carolina Specialty Eye Surgery, LLC CurrentSince Aug 5, 2024 Accepting new patients

Locations

1530 Boiling Springs Rd
Spartanburg, SC 29316
Phone (864) 583-6381

1520 Boiling Springs Rd
Spartanburg, SC 29316
Phone (864) 583-6381

Interoperability endpoints

  • Direct secure messaging: matthew.bickford.p1@direct.bostoneyegroup.nextgenshare.com
  • Direct secure messaging: mbickford@palmettoeyeandlaser.direct.eyemdemr.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1750841383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165121",
            "telephone_number": "864-505-6060",
            "fax_number": "843-876-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165121",
            "telephone_number": "864-505-6060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9228 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294069125",
            "country_code": "US",
            "telephone_number": "843-876-7080",
            "fax_number": "843-876-7111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9228 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294069125",
            "country_code": "US",
            "telephone_number": "843-876-7080",
            "fax_number": "843-876-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BICKFORD",
        "first_name": "MATTHEW",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "LL82611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boiling Springs, SC

Sources for this page

Verify at the official NPI Registry.