Individual provider Active NPI

Leslie Elizabeth Kirk, O.D.

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1871721910
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1557 Issued in SC
Practice address
3525 Park Avenue Blvd
Mount Pleasant, SC 29466
Phone
(843) 375-7036
Fax
(843) 375-7037
NPI assigned
Jun 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1557 SC Primary

Addresses

Primary practice location

3525 Park Avenue Blvd
Mount Pleasant, SC 29466

Mailing address

2362 Stevenson Dr
Charleston, SC 29414-7138
Phone (843) 513-8722

Other names 1

  • Dr. Leslie Elizabeth Patterson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180927001740 SC Practitioner - Optometry 1153672357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3525 Park Ave Blvd
Mount Pleasant, SC 29466-7242
Phone (843) 375-7036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye2Eye Vision Care, LLC Optometrist CurrentSince Aug 1, 2018 Accepting new patients

Locations

3525 Park Avenue Blvd
Mt Pleasant, SC 29466
Phone (843) 375-7031

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1871721910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2362 STEVENSON DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147138",
            "telephone_number": "843-513-8722",
            "fax_number": "843-501-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 PARK AVENUE BLVD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29466",
            "telephone_number": "843-375-7036",
            "fax_number": "843-375-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "LESLIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-28",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "PATTERSON",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.