PLAZA OPTICAL
NPI 1063694412
Eyewear Supplier in Eastman, GA
About Plaza Optical NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PLAZA OPTICAL (NPI 1063694412) is a healthcare organization registered as an eyewear supplier in Eastman, Georgia and active in the NPI registry since November 2007. The organization lists Jennifer A Roberts, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Plaza Optical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Plaza Optical, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John D Roberts Mdpc's NPI number?
The NPI number for John D Roberts Mdpc is 1063694412. It was assigned to this organization in the NPPES registry on November 28, 2007. The provider is doing business as Plaza Optical.
Where is John D Roberts Mdpc located?
John D Roberts Mdpc is located at 917 Plaza Ave, Eastman, GA 31023. The listed phone number is (478) 374-9767.
What is John D Roberts Mdpc's specialty?
The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.
Is John D Roberts Mdpc enrolled in Medicare?
Yes. John D Roberts Mdpc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through John D Roberts Mdpc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to John D Roberts Mdpc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for John D Roberts Mdpc was last updated on February 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Plaza Optical · NPI 1063694412
Eyewear Supplier organization in Eastman, Georgia. Organization record, active in the CMS NPPES registry since November 28, 2007.
## Identity
- **NPI:** 1063694412 (Entity type: Organization)
- **Enumerated:** November 28, 2007
- **Primary specialty:** Eyewear Supplier · taxonomy 332H00000X
- **Legal business name:** John D Roberts Mdpc
- **Organization subpart:** No
- **Authorized official:** Jennifer Roberts, MANAGER
## Practice location
- **Address:** 917 PLAZA AVE, Eastman, GA 31023-6759
- **Phone:** (478) 374-9767 · **Fax:** (478) 374-9769
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Ophthalmology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 5, 2008
- **Other identifiers:** Medicare NSC 4101390001 (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1063694412) · Data from the CMS NPPES public registry.