John E. Titak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

001466 Issued in GA

Practice address

3 Fairfield Dr
Avondale Estates, GA 30002-1421

Phone

(678) 432-3144

Fax

(678) 432-3420

NPI assigned

Mar 22, 2006

Last updated

Mar 31, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perry K Lee OD PCGroup PAC ID 8224149455, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.43 of 100Reported as group

Quality

74.86

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ecp_cecga
• Direct secure messaging: johnt@direct.eyecare-partners.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.

• Perry K Lee OD PC

  • Optometrist
  • Greensboro, GA
  • NPI 1184786683
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Georgia Inc

  dba Clarkson Eyecare

  • Optometrist
  • Alpharetta, GA
  • NPI 1184802670
  Medicare reassignment NPD
• M. Michael Pulliam, M.D., P.C.

  dba Pulliam Eye Group/Newton Rockdale ASC

  • Specialist
  • Covington, GA
  • NPI 1871635516
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1962461319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 FAIRFIELD DR",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021421",
            "telephone_number": "678-432-3144",
            "fax_number": "678-432-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FAIRFIELD DR",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021421",
            "telephone_number": "678-432-3144",
            "fax_number": "678-432-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITAK",
        "first_name": "JOHN",
        "middle_name": "E.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000743597N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Stentiford, DPT
• Amy Lynne Stern, LCSW
• Lisa D Taylor, PHD, TLP, LCSW
• Third Endeavor LLC
• Kevin Thrailkill, LCSW
• Trident Counseling and Consultation, LLC
• Jacqueline Varnum, PT, DPT, OCS, CSCS
• Verve Health LLC Dba Lyva Primary Care and Wellness Center
• Vivian Daniel Counseling LLC
• Charles Joseph Westbrook, PHD

• Optometrist in Avondale Estates, GA
• Providers in Avondale Estates, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.