Individual provider Active NPI

Brian E Saunders, OD

  • Optometrist
  • Marietta, GA
National Provider Identifier
1912974700
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001027 Issued in GA
Practice address
4690 Jefferson Township Lane
Marietta, GA 30066
Phone
(404) 402-7870
Fax
(770) 872-7463
NPI assigned
Mar 1, 2006
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001027 GA Primary

Addresses

Primary practice location

4690 Jefferson Township Lane
Marietta, GA 30066

Mailing address

4690 Jefferson Township Lane
Marietta, GA 30066
Phone (404) 402-7870

Other identifiers 1

IdentifierTypeStateIssuer
000396811AMedicaidGA

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
I20070517000264 GA Practitioner - Optometry 7810094398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

2453 Powder Springs SWRD
Suite 400
Marietta, GA 30064-4570
Phone (770) 801-0700

2990 Eagle Dr
Suite 110
Woodstock, GA 30189-5575
Phone (770) 427-8111

47 Highland Pavilion CT
Suite 101
Hiram, GA 30141-4261
Phone (770) 427-8111

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT001027GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic PA CurrentSince Jun 1, 2016 Accepting new patients
Marietta Eye Clinic, PA Optometrist CurrentSince Jun 1, 2016 Accepting new patients
Marietta Eye Clinic PA Current Accepting new patients
Marietta Eye Clinic, PA Optometrist PastSince Jan 29, 2023 Accepting new patients

Locations

4450 Calibre Xing NW
Ste 1104
Acworth, GA 30101
Phone (678) 279-1141

47 Highland Pavilion Ct
Ste 101
Atlanta, GA 31193

100 Old Ball Ground Hwy
#A
Canton, GA 30114

2453 Powder Springs Rd SW
Ste 400
Marietta, GA 30064
Phone (770) 801-0700

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

10485 Alpharetta St
Roswell, GA 30075
Phone (678) 439-2443

209 Cooley Dr
Ste 201
Villa Rica, GA 30180

2990 Eagle Dr
Ste 110
Woodstock, GA 30189
Phone (678) 460-4810

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1912974700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 JEFFERSON TOWNSHIP LANE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30066",
            "telephone_number": "404-402-7870",
            "fax_number": "770-872-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 JEFFERSON TOWNSHIP LANE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30066",
            "telephone_number": "404-402-7870",
            "fax_number": "770-872-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "BRIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000396811A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.