Individual provider Active NPI

Rajan Thomas, O.D.

  • Optometrist
  • Dacula, GA
National Provider Identifier
1972584308
Registry record updated Dec 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002340 Issued in GA
Practice address
1342 Auburn Rd Ste 112
Dacula, GA 30019-1675
Phone
(770) 237-8150
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002340 GA Primary

Addresses

Primary practice location

1342 Auburn Rd Ste 112
Dacula, GA 30019-1675

Mailing address

2962 Heart Pine Way
Buford, GA 30519-7639
Phone (845) 300-3792

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
I20180723000374 GA Practitioner - Optometry 5395762777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5550 Pkwy Blvd
Athens, GA 30606-6134
Phone (706) 247-8149

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006958NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Eyecare LLC Optometrist CurrentSince Nov 1, 2008 Accepting new patients
Veritas Eye Care LLC Optometrist CurrentSince Aug 7, 2024 Accepting new patients
Dr George T Roberts Optometrist PLLC Optometrist Past Accepting new patients

Locations

5550 Parkway Blvd
Athens, GA 30606
Phone (706) 247-8144

1342 Auburn Rd
Ste 112
Dacula, GA 30019
Phone (610) 800-1125

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480809600000",
    "number": "1972584308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2962 HEART PINE WAY",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305197639",
            "telephone_number": "845-300-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 AUBURN RD STE 112",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191675",
            "telephone_number": "770-237-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "RAJAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2016-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.