Organization Active NPI

Eye Site of Bluffton LLC

  • Optometrist
  • Bluffton, SC
National Provider Identifier
1902988173
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE SITE OF BLUFFTON LLC
Practice address
104 Buckwalter Pkwy
Unit 1 C
Bluffton, SC 29910-4131
Phone
(843) 757-9588
Fax
(843) 757-9589
NPI assigned
Oct 19, 2006
Last updated
May 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Authorized official

Name
Dr. Robert Szypczak, ODNPI 1841220878
Title
Optometrist/Owner
Phone
(843) 757-9588

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

104 Buckwalter Pkwy
Unit 1 C
Bluffton, SC 29910-4131

Mailing address

104 Buckwalter Pkwy
Unit 1 C
Bluffton, SC 29910-4131
Phone (843) 757-9588

Other identifiers 1

IdentifierTypeStateIssuer
DA9667MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061121000667 SC Part B Supplier - Clinic/Group Practice 9335147560 Receives reassigned benefits from 4 practitioners
Practice locations: Bluffton, SC

National Provider Directory

National Provider Directory

Locations

104 Buckwalter Pkwy
Ste 1C
Bluffton, SC 29910
Phone (843) 540-2327

Practitioners & affiliated clinicians

Practitioners 5

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": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1902988173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BUCKWALTER PKWY",
            "address_2": "UNIT 1 C",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104131",
            "telephone_number": "843-757-9588",
            "fax_number": "843-757-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BUCKWALTER PKWY",
            "address_2": "UNIT 1 C",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104131",
            "telephone_number": "843-757-9588",
            "fax_number": "843-757-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SITE OF BLUFFTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "SZYPCZAK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "843-757-9588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9667",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.