Individual provider Active NPI

David A Altman, O. D.

  • Optometrist
  • McRae, GA
National Provider Identifier
1831231653
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
873 Issued in GA
Practice address
119 W Pine St
McRae, GA 31055-1668
Phone
(229) 868-6312
Fax
(229) 868-5330
NPI assigned
Feb 12, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 873 GA Primary

Addresses

Primary practice location

119 W Pine St
McRae, GA 31055-1668

Mailing address

119 W Pine St
McRae, GA 31055-1668
Phone (229) 868-6312

Other identifiers 2

IdentifierTypeStateIssuer
39404MedicaidGA
00378463AMedicaidGA

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
I20100526000832 GA Practitioner - Optometry 1052440245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 W Pine St
McRae, GA 31055-4528
Phone (229) 868-6312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
873GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Altman Eye Clinic, P.C. Optometrist CurrentSince Apr 17, 2012 Accepting new patients

Locations

11 W Pine St
Mc Rae Helena, GA 31055
Phone (229) 868-6312

Organizations & group practices 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831231653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W PINE ST",
            "city": "MCRAE",
            "state": "GA",
            "postal_code": "310551668",
            "telephone_number": "229-868-6312",
            "fax_number": "229-868-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W PINE ST",
            "city": "MCRAE",
            "state": "GA",
            "postal_code": "310551668",
            "telephone_number": "229-868-6312",
            "fax_number": "229-868-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39404",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00378463A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McRae, GA

Sources for this page

Verify at the official NPI Registry.