Organization Active NPI

Comprehensive Eyecare LLC

Doing business as Comprehensive Eye

  • Optometrist
  • Pooler, GA
National Provider Identifier
1932778206
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COMPREHENSIVE EYECARE LLC
Doing business as
Comprehensive Eye
Practice address
200 Mosaic Cir
Pooler, GA 31322-5025
Phone
(912) 348-4584
NPI assigned
Jun 22, 2021
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Chelsea Ryzuk
Title
Optometrist
Phone
(912) 348-4584

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

200 Mosaic Cir
Pooler, GA 31322-5025

Mailing address

200 Mosaic Cir
Pooler, GA 31322-5025
Phone (912) 348-4584

Other names 1

  • Comprehensive Eye Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.revolutionehr.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211205000022 GA Part B Supplier - Clinic/Group Practice 0840695557 Receives reassigned benefits from 6 practitioners
Practice locations: Pooler, GA; Alpharetta, GA

National Provider Directory

National Provider Directory

Locations

2111 Pooler Pkwy
Pooler, GA 31322
Phone (843) 481-5459

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1932778206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MOSAIC CIR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313225025",
            "telephone_number": "912-348-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MOSAIC CIR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313225025",
            "telephone_number": "912-348-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "RYZUK",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "912-348-4584"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.revolutionehr.com",
            "affiliation": "N",
            "address_1": "200 Mosaic Cir",
            "city": "Pooler",
            "state": "GA",
            "country_code": "US",
            "postal_code": "313225025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Comprehensive Eye",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comprehensive Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.