Sushmita De Allen, OD

Individual provider Active NPI Optometrist · Jamestown, NC

NPI 1891706511 · NPPES record last updated Oct 2, 2019

Key facts

NPI
1891706511
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
1254 (NC)
Practice address
205A Hillstone PL
Jamestown, NC 27282-2000
Phone
(336) 454-5151
Fax
(336) 841-2062
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Optometry
Education
Pennsylvania College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 A Hillstone PL
Jamestown, NC 27282-2000

207 -B Oakdale Rd
Jamestown, NC 27282-9256
Phone (336) 454-5151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery37

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120302000132 NC Practitioner - Optometry 0446419980 Practice locations: Jamestown, NC

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1254NCMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1254 NC Yes

Addresses

Primary practice location

205A Hillstone PL
Jamestown, NC 27282-2000

Mailing address

PO Box 1288
Jamestown, NC 27282-1288
Phone (336) 454-5151

Other identifiers

IdentifierTypeStateIssuer
2200711OtherUHC
0901GOtherBCBS
890901GMedicaidNC

Other providers in Jamestown, NC

All providers in Jamestown, NC · Optometrist in North Carolina

Sources for this page

Verify at the official NPI Registry.