VISION SOURCE - PROFESSIONAL EYE CARE
NPI 1225199979
Optometrist in Statesboro, GA
About Vision Source - Professional Eye Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VISION SOURCE - PROFESSIONAL EYE CARE (NPI 1225199979) is a healthcare organization registered as an optometrist in Statesboro, Georgia and active in the NPI registry since December 2006. The organization lists Horace E Deal, Owner, Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vision Source - Professional Eye Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Vision Source - Professional Eye Care, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Southeastern Eye Clinic PC's NPI number?
The NPI number for Southeastern Eye Clinic PC is 1225199979. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider is doing business as Vision Source - Professional Eye Care.
Where is Southeastern Eye Clinic PC located?
Southeastern Eye Clinic PC is located at 214 Savannah Ave, Statesboro, GA 30458. The listed phone number is (912) 764-5609.
What is Southeastern Eye Clinic PC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Southeastern Eye Clinic PC enrolled in Medicare?
Yes. Southeastern Eye Clinic PC is registered in the Medicare PECOS enrollment system.
When is Southeastern Eye Clinic PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southeastern Eye Clinic PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Southeastern Eye Clinic PC. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southeastern Eye Clinic PC accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Southeastern Eye Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southeastern Eye Clinic PC was last updated on June 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Vision Source - Professional Eye Care · NPI 1225199979
Optometrist organization in Statesboro, Georgia. Organization record, active in the CMS NPPES registry since December 13, 2006.
## Identity
- **NPI:** 1225199979 (Entity type: Organization)
- **Enumerated:** December 13, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Southeastern Eye Clinic Pc
- **Organization subpart:** No
- **Authorized official:** Horace Deal, OWNER, PROVIDER
## Practice location
- **Address:** 214 SAVANNAH AVE, Statesboro, GA 30458-5165
- **Phone:** (912) 764-5609 · **Fax:** (912) 764-7786
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 24, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1225199979) · Data from the CMS NPPES public registry.