Individual provider Active NPI

Fouad S Allouch, O.D

  • Optometrist
  • Myrtle Beach, SC
National Provider Identifier
1972676203
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1211 Issued in SC
Practice address
2703 N Kings Hwy
Myrtle Beach, SC 29577-3011
Phone
(843) 448-1596
Fax
(843) 448-4793
NPI assigned
Nov 16, 2006
Last updated
Feb 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1211 SC Primary

Addresses

Primary practice location

2703 N Kings Hwy
Myrtle Beach, SC 29577-3011

Mailing address

2703 N Kings Hwy
Myrtle Beach, SC 29577-3011
Phone (843) 448-1596

Other identifiers 2

IdentifierTypeStateIssuer
D12118MedicaidSC
U86668995OtherSCMEDICARE PTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040324000526 SC Practitioner - Optometry 9830080159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

706 Sea Mountain Hwy
North Myrtle Beach, SC 29582-2347
Phone (843) 249-8440

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1211SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allouch Optometric, PC Optometrist CurrentSince Mar 24, 2008 Accepting new patients
Cherry Grove Eye Care Optometrist Past Accepting new patients
East Coast Optometric, Inc. Optometrist Past Accepting new patients
Singleton Eye Inc Past Accepting new patients

Locations

2703 N Kings Hwy
Myrtle Beach, SC 29577
Phone (843) 251-7162

352 Seaboard St
Myrtle Beach, SC 29577

706 Sea Mountain Hwy
North Myrtle Beach, SC 29582
Phone (843) 249-8440

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296691200000",
    "number": "1972676203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773011",
            "telephone_number": "843-448-1596",
            "fax_number": "843-448-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773011",
            "telephone_number": "843-448-1596",
            "fax_number": "843-448-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLOUCH",
        "first_name": "FOUAD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D12118",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U86668995",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.