Ivana Obradovic, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4521 Issued in FL

Practice address

2460 India Hook Rd Ste 206
Rock Hill, SC 29732-3578

Phone

(803) 985-2020

Fax

(803) 985-2021

NPI assigned

Sep 14, 2010

Last updated

Jun 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Optometry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palmetto Eyecare Associates P aGroup PAC ID 4789866963, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivana.obradovic@uprisedirect.com

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.

• Palmetto Eyecare Associates P a

  • Optometrist
  • Rock Hill, SC
  • NPI 1134364128
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1942518774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3176 S UNIVERSITY DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253002",
            "telephone_number": "954-431-2020",
            "fax_number": "954-435-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 INDIA HOOK RD STE 206",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323578",
            "telephone_number": "803-985-2020",
            "fax_number": "803-985-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3176 S University Dr",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330253002",
            "country_code": "US",
            "telephone_number": "954-431-2020",
            "fax_number": "954-435-7124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBRADOVIC",
        "first_name": "IVANA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2256",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D22562",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003809600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003110735A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Carmen O'Dell
• Devin Mills O'Keefe, DPT
• Michael Paul O'Neill, D.D.S.
• Stacey O'Neill, ATC
• Oakview Dermatology
• Occupational Health Centers of the Southwest P.a. (Concentra Medical Centers)
• Tajaylah Lakaisha Odom
• Stephen Frederick Oehme, MD
• Jane Elizabeth Oei, RN, BS, MSN, FNP-BC
• Kristina L Ogilvie, LPC

• Optometrist in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.