Individual provider Active NPI

Charles W Ficco, O.D.

  • Optometrist
  • Cumming, GA
National Provider Identifier
1841284346
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT01583 Issued in GA
Practice address
970 Sanders Rd Ste 100
Cumming, GA 30041
Phone
(678) 381-2020
Fax
(678) 381-2015
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 OPT01583 GA Primary

Addresses

Primary practice location

970 Sanders Rd Ste 100
Cumming, GA 30041

Mailing address

1300 Peachtree Industrial Blvd Ste 1201
Suwanee, GA 30024-4550
Phone (678) 381-2020

Other practice location 1

1000 Corporate Center Dr
Ste 100
Morrow, GA 30260-4180
Phone (770) 968-8888

Other practice location 2

1000 Corporate Center Dr
Ste 100
Morrow, GA 30260-4180
Phone (770) 968-8888

Other identifiers 2

IdentifierTypeStateIssuer
C16012OtherGARAILROAD MEDICARE
000741815AMedicaidGA

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
I20111103000363 GA Practitioner - Optometry 2163695339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milan Eye LLCGroup PAC ID 2668519109, 21 clinicians

Practice addresses (Care Compare)

1034 Haw Creek Cir
Suite 100
Cumming, GA 30041-6513
Phone (678) 381-2020

11315 Johns Creek Pkwy
Suite 300
Johns Creek, GA 30097-1517
Phone (678) 381-2020

2555 Westside Pkwy
Suite 300
Alpharetta, GA 30004-4191
Phone (678) 381-2020

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
94
Promoting interoperability
71
Improvement activities
40
Cost
77.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT01583GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Milan Eye LLC CurrentSince Jul 1, 2016 Accepting new patients
Buford Eye Surgery Center Past Accepting new patients
Alpharetta Eye Surgery Center LLC Past Accepting new patients

Locations

201 Kimberly Way
Ste 200
Canton, GA 30114

970 Sanders Rd
Ste 100
Cumming, GA 30041

270 Walmart Way
Dahlonega, GA 30533
Phone (706) 867-6918

1300 Peachtree Industrial Blvd
Ste 1201
Suwanee, GA 30024
Phone (770) 614-6266

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1841284346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 1201",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244550",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 SANDERS RD STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Corporate Center Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Morrow",
            "state": "GA",
            "postal_code": "302604180",
            "country_code": "US",
            "telephone_number": "770-968-8888",
            "fax_number": "770-960-2473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Corporate Center Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Morrow",
            "state": "GA",
            "postal_code": "302604180",
            "country_code": "US",
            "telephone_number": "770-968-8888",
            "fax_number": "770-960-2473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FICCO",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT01583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C16012",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000741815A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.