Lake Norman Ophthalmology PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

LAKE NORMAN OPHTHALMOLOGY PLLC

Practice address

132 Gateway Blvd Ste C
Mooresville, NC 28117-5540

Phone

(704) 662-3875

Fax

(704) 662-3875

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tushar Patel, MDNPI 1922012103

Title

Owner

Phone

(704) 663-7226

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tushar Raman Patel, MD

  • Specialist
  • Mooresville, NC
  • NPI 1922012103
  Medicare reassignment Care Compare group NPD Authorized official
• Eric L Intihar, OD

  • Optometrist
  • Mooresville, NC
  • NPI 1396177085
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1821147133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 GATEWAY BLVD STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175540",
            "telephone_number": "704-662-3875",
            "fax_number": "704-662-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 GATEWAY BLVD STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175540",
            "telephone_number": "704-662-3875",
            "fax_number": "704-662-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN OPHTHALMOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "TUSHAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-663-7226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015UE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Norman Muay Thai LLC
• Lake Norman Neurological and Spinal Surgery, P.a.
• Lake Norman Neurology
• Lake Norman Neurology PA
• Lake Norman OBGYN LLP
• Lake Norman Pain and Weight Management, LLC
• Lake Norman Pediatrics, PA
• Lake Norman Plastic Surgery
• Lake Norman Psychiatry & Counseling, PLLC
• Lake Norman Pulmonary & Sleep, PA

• Ophthalmology Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.