Mary Lou C Puglese, OD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

115 Cynthia St
Clinton, MS 39056-3711

Phone

(601) 924-4444

Fax

(601) 924-5471

NPI assigned

May 13, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Optometry

Education

Southern College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optical 2000Group PAC ID 8729983325, 4 clinicians

Optical 2000 of RichlandGroup PAC ID 1456439082, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optical 2000

  • Optometrist
  • Clinton, MS
  • NPI 1144422577
  Medicare reassignment Care Compare group NPD
• Optical 2000 of Richland

  • Optometrist
  • Richland, MS
  • NPI 1205001005
  Medicare reassignment Care Compare group
• Optical 2000 of Flora PA

  • Optometrist
  • Flora, MS
  • NPI 1447794797
  NPD (past)

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1780432880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CYNTHIA ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563711",
            "telephone_number": "601-924-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CYNTHIA ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563711",
            "telephone_number": "601-924-4444",
            "fax_number": "601-924-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGLESE",
        "first_name": "MARY LOU",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Brooks Prewitt, EDS, LCSW
• Rachel Lani Price
• Prime Care Clinic of Clinton, LLC
• Provision Processing Solutions LLC
• Psychological Consultants PA
• Pure Joy Mississippi, LLC
• Pure Joy Mississippi, LLC
• Purity Services LLC
• Purplebutterfly, LLC
• Quad Intermed Company LLC

• Student in an Organized Health Care Education/Training Program in Clinton, MS
• Providers in Clinton, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.