Individual provider Active NPI

Boston Perkins, O.D.

  • Corneal and Contact Management Optometrist
  • Florence, SC
National Provider Identifier
1902357791
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
1968 Issued in SC
Practice address
1945 W Palmetto St
Suite 111
Florence, SC 29501-3919
Phone
(843) 679-1812
NPI assigned
Oct 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 1968 SC Primary

Addresses

Primary practice location

1945 W Palmetto St
Suite 111
Florence, SC 29501-3919

Mailing address

1945 W Palmetto St
Suite 111
Florence, SC 29501-3919
Phone (843) 679-1812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170503002006 NC Practitioner - Optometry 7618254483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peterson Optometric Group PLLCGroup PAC ID 8527354471, 2 clinicians

Practice addresses (Care Compare)

4514 Oleander Dr
Wilmington, NC 28403-5012
Phone (910) 392-4414

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2475NCMDPediatric Physical Therapist
1968SCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Optometric Group, PLLC Corneal and Contact Management CurrentSince Mar 1, 2017 Accepting new patients
America'S Best Contact & Eyeglasses Past Accepting new patients

Locations

4514 Oleander Dr
Wilmington, NC 28403
Phone (910) 392-4414

Organizations & group practices 2

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1902357791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W PALMETTO ST",
            "address_2": "SUITE 111",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013919",
            "telephone_number": "843-679-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W PALMETTO ST",
            "address_2": "SUITE 111",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013919",
            "telephone_number": "843-679-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "BOSTON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SC",
            "license": "1968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.