Organization Active NPI

Decatur Eye Care

  • Optometrist
  • Decatur, GA
National Provider Identifier
1902433691
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DECATUR EYE CARE
Practice address
321 W Hill St Ste 6
Decatur, GA 30030-4362
Phone
(404) 371-8777
Fax
(404) 371-9384
NPI assigned
Mar 24, 2020
Last updated
Mar 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Authorized official

Name
Dr. Thomas Christopher Brillante, ODNPI 1346389301
Title
Owner
Phone
(404) 550-6779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

321 W Hill St Ste 6
Decatur, GA 30030-4362

Mailing address

321 W Hill St Ste 6
Decatur, GA 30030-4362
Phone (404) 371-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430002829 GA Part B Supplier - Clinic/Group Practice 1759711914 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, GA

National Provider Directory

National Provider Directory

Locations

321 W Hill St
Ste 6
Decatur, GA 30030
Phone (404) 371-8777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1902433691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W HILL ST STE 6",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304362",
            "telephone_number": "404-371-8777",
            "fax_number": "404-371-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W HILL ST STE 6",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304362",
            "telephone_number": "404-371-8777",
            "fax_number": "404-371-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "BRILLANTE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-550-6779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.