Individual provider Active NPI

Nicole Lynch, O.D.

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1972837805
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2177 Issued in NC
Practice address
1994 S 17TH St
Wilmington, NC 28401-6627
Phone
(910) 254-9292
Fax
(910) 254-9294
NPI assigned
Sep 24, 2009
Last updated
May 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2177 NC Primary

Addresses

Primary practice location

1994 S 17TH St
Wilmington, NC 28401-6627

Mailing address

1994 S 17TH St
Wilmington, NC 28401-6627
Phone (910) 254-9292

Other identifiers 2

IdentifierTypeStateIssuer
5912915MedicaidNC
0930GOtherNCBCBS OF NC

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
I20091026000699 NC Practitioner - Optometry 2264579168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gaston Eye AssociatesGroup PAC ID 7618945437, 10 clinicians

Practice addresses (Care Compare)

2325 Aberdeen Blvd a
Gastonia, NC 28054-0642
Phone (704) 853-3937

Merit-based Incentive Payment System (MIPS)

Final score
86.21 of 100Reported as group
Quality
80.98
Improvement activities
40
Cost
79.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2177NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Eye Associates Optometrist CurrentSince Jun 6, 2022 Accepting new patients
Gaston Eye Associates Optometrist CurrentSince Jun 6, 2022 Accepting new patients
Albemarle Eye Center, PLLC Optometrist Past Accepting new patients

Locations

2325 Aberdeen Blvd
Ste A
Gastonia, NC 28054
Phone (704) 853-3937

Interoperability endpoints

  • Direct secure messaging: nlynch@gastoneye.eyeclinicdirect.net

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, 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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1972837805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016627",
            "telephone_number": "910-254-9292",
            "fax_number": "910-254-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1994 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016627",
            "telephone_number": "910-254-9292",
            "fax_number": "910-254-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "NICOLE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5912915",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0930G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.