Individual provider Active NPI

Frederic A Munz, O.D.

  • Optometrist
  • Wake Forest, NC
National Provider Identifier
1912908872
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
955 Issued in NC
Practice address
12205 Capital Blvd
Wake Forest, NC 27587-6200
Phone
(919) 554-2020
Fax
(919) 556-4047
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601000817 VA
Optometrist 152W00000X 955 NC Primary

Addresses

Primary practice location

12205 Capital Blvd
Wake Forest, NC 27587-6200

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other identifiers 3

IdentifierTypeStateIssuer
8909640MedicaidNC
09640OtherNCBCBS PROV #
540004216OtherNCRR MEDICARE INDIVIDUAL #

Other names 1

  • Ric Munz Professional name

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
I20100811000151 NC Practitioner - Optometry 6002710555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0601000817VAMDOptometrist
0955NCMDSpecialist
955NCMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 2, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 2, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

3905 New Bern Ave
Raleigh, NC 27610
Phone (919) 231-6040

14460 Falls of Neuse Rd
Ste 125
Raleigh, NC 27614
Phone (919) 847-4665

901 N Winstead Ave
Ste 190
Rocky Mount, NC 27804
Phone (252) 355-7301

110 Capcom Ave
Ste 100
Wake Forest, NC 27587
Phone (919) 554-3227

12205 Capital Blvd
Wake Forest, NC 27587
Phone (919) 554-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1912908872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12205 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876200",
            "telephone_number": "919-554-2020",
            "fax_number": "919-556-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNZ",
        "first_name": "FREDERIC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601000817",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909640",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "09640",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL #",
            "identifier": "540004216",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RIC",
            "last_name": "MUNZ",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.