Active Life Eye Care, Od, Pa is a medicare enrolled "Optometrist" provider in Madison, North Carolina. Their current practice location is
415 W Academy St, Madison, North Carolina. You can reach out to their office (for appointments etc.) via phone at
(336) 404-6235.
Active Life Eye Care, Od, Pa is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Active Life Eye Care, Od, Pa
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1740663855.
Healthcare Provider's Profile
Full Name | Active Life Eye Care, Od, Pa |
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Type | Facility |
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Speciality | Optometrist |
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Location | 415 W Academy St, Madison, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1740663855
- Provider Enumeration Date: 07/07/2015
- Last Update Date: 01/11/2016
Medicare PECOS Information:
- PECOS PAC ID: 5597075259
- Enrollment ID: O20151109001223
Medical Identifiers
Medical identifiers for Active Life Eye Care, Od, Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1740663855 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Active Life Eye Care, Od, Pa acts as a billing entity for following providers:
Provider Name | Brent B Johnson |
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Provider Type | Practitioner - Optometry |
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Provider Identifiers | NPI Number: 1235239641 PECOS PAC ID: 0446226476 Enrollment ID: I20160112001715 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Active Life Eye Care, Od, Pa is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Active Life Eye Care, Od, Pa 415 W Academy St, Madison, NC 27025-2005 Ph: (336) 404-6235 | Active Life Eye Care, Od, Pa 415 W Academy St, Madison, NC 27025-2005 Ph: (336) 404-6235 |
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