Individual provider Active NPI

Zachary Robert Engle, O.D.

  • Optometrist
  • Fayetteville, NC
National Provider Identifier
1912257247
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2276 Issued in NC
Practice address
419 Cross Creek Mall
Ste 302
Fayetteville, NC 28303-7285
Phone
(919) 782-9091
Fax
(919) 782-9135
NPI assigned
Sep 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2276 NC Primary

Addresses

Primary practice location

419 Cross Creek Mall
Ste 302
Fayetteville, NC 28303-7285

Mailing address

4351 The Circle at North Hills St
Ste 107
Raleigh, NC 27609-5751
Phone (919) 782-9091

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
I20121015000500 NC Practitioner - Optometry 2264682988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Center Doctors of Optometry PAGroup PAC ID 6901883362, 12 clinicians

Practice addresses (Care Compare)

302 Cross Creek Mall
Fayetteville, NC 28303-7242
Phone (910) 867-4466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2276NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Center, Doctors of Optometry, P.a. Optometrist CurrentSince Jul 1, 2015 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

302 Cross CRK Mall
Fayetteville, NC 28303
Phone (910) 867-4466

4351 The Cir At North Hills St
Ste 107
Raleigh, NC 27609
Phone (919) 782-9091

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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1912257247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 THE CIRCLE AT NORTH HILLS ST",
            "address_2": "STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095751",
            "telephone_number": "919-782-9091",
            "fax_number": "919-782-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 CROSS CREEK MALL",
            "address_2": "STE 302",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037285",
            "telephone_number": "919-782-9091",
            "fax_number": "919-782-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLE",
        "first_name": "ZACHARY",
        "middle_name": "ROBERT",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.