Horn Lake Eyecare Pllc is a medicare enrolled "Optometrist" provider in Horn Lake, Mississippi. Their current practice location is
2085 Goodman Rd, Horn Lake, Mississippi. You can reach out to their office (for appointments etc.) via phone at
(662) 893-3300.
Horn Lake Eyecare Pllc is licensed to practice in Mississippi (license number 606) and it also participates in the medicare program. Horn Lake Eyecare Pllc
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 1609116581.
Healthcare Provider's Profile
| Full Name | Horn Lake Eyecare Pllc |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 2085 Goodman Rd, Horn Lake, 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: 1609116581
- Provider Enumeration Date: 02/28/2013
- Last Update Date: 02/28/2013
Medicare PECOS Information:
- PECOS PAC ID: 4486889284
- Enrollment ID: O20131104000443
Medical Identifiers
Medical identifiers for Horn Lake Eyecare Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609116581 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 606 (Mississippi) | Primary |
| 152W00000X | Optometrist | 647 (Mississippi) | Secondary |
| 152W00000X | Optometrist | 681 (Mississippi) | Secondary |
| 152W00000X | Optometrist | 857 (Mississippi) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Horn Lake Eyecare Pllc acts as a billing entity for following providers:
| Provider Name | Nicole Y Monroe |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1700862042
PECOS PAC ID: 0143274340
Enrollment ID: I20050310000446 |
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| Provider Name | Walter Pang |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1548692130
PECOS PAC ID: 4284858473
Enrollment ID: I20140609001556 |
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| Provider Name | Justin Mcelroy |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1962925214
PECOS PAC ID: 0941568760
Enrollment ID: I20171227000576 |
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| Provider Name | Mallory Phillips Bodford |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1932518032
PECOS PAC ID: 1658704010
Enrollment ID: I20191126001158 |
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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. Horn Lake Eyecare Pllc 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 |
|---|
Horn Lake Eyecare Pllc
6947 Crumpler Blvd, Suite 100,
Olive Branch, MS 38654-1922
Ph: (662) 893-3300 | Horn Lake Eyecare Pllc
2085 Goodman Rd,
Horn Lake, MS 38637
Ph: (662) 893-3300 |
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