MARIETTA EYE CLINIC, PA
NPI 1255333175
Ophthalmology in Marietta, GA
NPI Status: Active since August 11, 2005
Contact Information
895 CANTON RD NE
BUILDING 100
MARIETTA, GA
ZIP 30060
Phone: (770) 427-8111
Fax: (770) 499-1643
- Organization
- Ophthalmology
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 11D1004717
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-15-2028
About MARIETTA EYE CLINIC, PA
This page provides the complete NPI Profile along with additional information for Marietta Eye Clinic, Pa, a provider established in Marietta, Georgia operating as a Ophthalmology. The healthcare provider is registered in the NPI registry with number 1255333175 assigned on August 2005. The practitioner's primary taxonomy code is 207W00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Marietta Eye Clinic, Pa operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Henry Elliott Gatehouse (Senior Director)
- NPI
- 1255333175
- Provider Name
- MARIETTA EYE CLINIC, PA
- Entity Type
- Organization
- Location Address
- 895 CANTON RD NE BUILDING 100 MARIETTA, GA 30060
- Location Phone
- (770) 427-8111
- Location Fax
- (770) 499-1643
- Mailing Address
- 895 CANTON RD NE BUILDING 100 MARIETTA, GA 30060
- Mailing Phone
- (770) 427-8111
- Mailing Fax
- (770) 499-1643
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-11-2005
- Last Update Date
- 05-15-2018
- Code Navigator
Ophthalmologists like Marietta Eye Clinic, Pa specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Marietta Eye Clinic, Pa is a medicare supplier with PTAN 20621807 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Contact Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 152W00000X | Eye and Vision Services Providers | Optometrist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20621807
- Accepts Medicare Assignment
- YES
- Specialities List
- Optician.
- Provider Type List
- PHYSICIAN – OPHTHALMOLOGY.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D1004717
- Facility Type
- Physician Office
- Certificate Effective Date
- January 16, 2026
- Certificate Expiration Date
- January 15, 2028
- Laboratory Director
- ANDRE S. COHEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Marietta Eye Clinic, Pa to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1255333175, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MARIETTA, GA 30060
MARIETTA, GA 30060
MARIETTA, GA 30060
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255333175, enumerated as an "organization" on August 11, 2005.
The provider is located at 895 CANTON RD NE BUILDING 100 MARIETTA, GA 30060 and the phone number is (770) 427-8111.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee. Please consult your insurance carrier or call the provider to verify.
