Individual provider Active NPI

Vixitkumar Patel, OD

  • Optometrist
  • Buford, GA
National Provider Identifier
1790205672
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003019 Issued in GA
Practice address
3264 Buford Dr Ste 100a
Buford, GA 30519-8743
Phone
(678) 395-2020
NPI assigned
Jun 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003019 GA Primary

Addresses

Primary practice location

3264 Buford Dr Ste 100a
Buford, GA 30519-8743

Mailing address

300B Sterling CT
Statesboro, GA 30458-9026
Phone (912) 656-9264

Other practice location 1

324 Newnan Crossing Byp
Newnan, GA 30265-1082
Phone (678) 423-3927

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
I20180519000054 GA Practitioner - Optometry 8022373125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

85 Old Farm Rd
Suite 110
Jefferson, GA 30549-2965
Phone (706) 203-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Lynn O.D. & Associates, PC CurrentSince Dec 6, 2017 Accepting new patients
Sai Eye Care LLC Optometrist CurrentSince May 1, 2024 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Dec 6, 2017 Accepting new patients

Locations

85 Old Farm Rd
Ste 110
Jefferson, GA 30549
Phone (706) 203-5777

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

324 Newnan Crossing Byp
Newnan, GA 30265
Phone (678) 423-3927

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1790205672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300B STERLING CT",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589026",
            "telephone_number": "912-656-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 BUFORD DR STE 100A",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198743",
            "telephone_number": "678-395-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 Newnan Crossing Byp",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302651082",
            "country_code": "US",
            "telephone_number": "678-423-3927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VIXITKUMAR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

Verify at the official NPI Registry.