Individual provider Active NPI

Angela Everett Macdonald, O.D.

  • Optometrist
  • Jacksonville, NC
National Provider Identifier
1952405417
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2031 Issued in NC
Practice address
315A Western Boulevard
Jacksonville, NC 28546-6338
Phone
(910) 353-1011
Fax
(910) 353-4433
NPI assigned
Sep 12, 2006
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2031 NC Primary

Addresses

Primary practice location

315A Western Boulevard
Jacksonville, NC 28546-6338

Mailing address

315A Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 353-1011

Other identifiers 2

IdentifierTypeStateIssuer
5905963MedicaidNC
093WAOtherNCBCBSNC

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
I20071211000503 NC Practitioner - Optometry 0749377018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecarecenter OD PAGroup PAC ID 7315834462, 71 clinicians

Practice addresses (Care Compare)

775 W Corbett Ave
Suite 1
Swansboro, NC 28584-8563
Phone (910) 326-3050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2031NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter, O.D., P.a. Optometrist CurrentSince Apr 1, 2011 Accepting new patients
Eyecarecenter OD PA Optometrist Current Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince Apr 1, 2011 Accepting new patients
C.V. Sikes,Jr. & R.B. Gotschalk PTR Optometrist Past Accepting new patients
Eyecarecenter OD PA Optometrist PastSince Feb 27, 2022 Accepting new patients
Eyecarecenter, O.D., P.a. Optometrist Past Accepting new patients

Locations

315 Western Blvd
#A
Jacksonville, NC 28546
Phone (910) 353-1011

315A Western Blvd
Jacksonville, NC 28546
Phone (910) 353-1011

4130 Western Blvd
Jacksonville, NC 28546
Phone (910) 353-9200

2001 S Glenburnie Rd
New Bern, NC 28562
Phone (252) 633-6900

819 Tiffany Blvd
Rocky Mount, NC 27804
Phone (252) 972-2020

775 W Corbett Ave
Ste 1
Swansboro, NC 28584
Phone (910) 326-3050

Interoperability endpoints

  • Direct secure messaging: amacdonald1@direct.eyecare-partners.com

Organizations & group practices 6

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1952405417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315A WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-353-1011",
            "fax_number": "910-353-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315A WESTERN BOULEVARD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-353-1011",
            "fax_number": "910-353-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "ANGELA",
        "middle_name": "EVERETT",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905963",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "093WA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.