The Eye Clinic Pa is a medicare enrolled "Eyewear Supplier" provider in Gulfport, Mississippi. Their current practice location is
1900 23rd Ave, Gulfport, Mississippi. You can reach out to their office (for appointments etc.) via phone at
(228) 864-2633.
The Eye Clinic Pa is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. The Eye Clinic 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 1427002864.
Healthcare Provider's Profile
| Full Name | The Eye Clinic Pa |
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| Type | Facility |
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| Speciality | Eyewear Supplier |
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| Location | 1900 23rd Ave, Gulfport, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1427002864
- Provider Enumeration Date: 05/20/2006
- Last Update Date: 04/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 6204848831
- Enrollment ID: O20060626000133
Medical Identifiers
Medical identifiers for The Eye Clinic Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427002864 | NPI | - | NPPES |
| 09013545 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (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.
The Eye Clinic Pa acts as a billing entity for following providers:
| Provider Name | Joe R Mitchell |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1508949355
PECOS PAC ID: 1850495243
Enrollment ID: I20070323000362 |
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| Provider Name | Roderick D Fields |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1073595906
PECOS PAC ID: 2062572639
Enrollment ID: I20081201000190 |
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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. The Eye Clinic 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 |
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The Eye Clinic Pa
Po Box 148,
Gulfport, MS 39502-0148
Ph: (228) 864-2633 | The Eye Clinic Pa
1900 23rd Ave,
Gulfport, MS 39501-2965
Ph: (228) 864-2633 |
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