Individual provider Active NPI

Eunice Mihyun Yi, O.D.

  • Optometrist
  • Dacula, GA
National Provider Identifier
1912356601
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003046 Issued in GA
Practice address
3511 Braselton Hwy
Ste G-200
Dacula, GA 30019-5927
Phone
(678) 916-5840
Fax
(678) 916-5844
NPI assigned
Jun 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003046 GA Primary

Addresses

Primary practice location

3511 Braselton Hwy
Ste G-200
Dacula, GA 30019-5927

Mailing address

3511 Braselton Hwy.
Ste G-200
Dacula, GA 30019-5927
Phone (678) 916-5840

Other practice location 1

4153 Lavista Rd Ste C
Tucker, GA 30084-5344
Phone (770) 939-8828

Other names 1

  • Mi Hyun Yi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180719002936 GA Practitioner - Optometry 8325395486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
C and Y Doctors of Optometry IncGroup PAC ID 8628440013, 2 clinicians

Practice addresses (Care Compare)

3511 Braselton Hwy
Suite G 200
Dacula, GA 30019-5927
Phone (678) 916-5840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Jul 14, 2022 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Jul 14, 2022 Accepting new patients
C & Y Doctors of Optometry, Inc Optometrist CurrentSince Mar 1, 2023 Accepting new patients
Divine Eye Care Inc. Optometrist Past Accepting new patients

Locations

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

3511 Braselton Hwy
Ste G-200
Dacula, GA 30019
Phone (678) 916-5840

6700 Douglas Blvd
Ste 1550
Douglasville, GA 30135
Phone (770) 852-1002

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

4153 Lavista Rd
Ste C
Tucker, GA 30084
Phone (770) 939-8828

Organizations & group practices 4

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1912356601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 BRASELTON HWY.",
            "address_2": "STE G-200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195927",
            "telephone_number": "678-916-5840",
            "fax_number": "678-916-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 BRASELTON HWY",
            "address_2": "STE G-200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195927",
            "telephone_number": "678-916-5840",
            "fax_number": "678-916-5844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4153 Lavista Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300845344",
            "country_code": "US",
            "telephone_number": "770-939-8828",
            "fax_number": "770-939-3966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YI",
        "first_name": "EUNICE",
        "middle_name": "MIHYUN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MI HYUN",
            "last_name": "YI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.