MARIETTA EYE CLINIC, PA – Ophthalmology Physician, NPI 1013079375

MARIETTA EYE CLINIC, PA is a healthcare provider. based in Douglasville, Georgia. specializing in Ophthalmology Physician. The NPI Number for MARIETTA EYE CLINIC, PA is 1013079375

Main info

Organization
Name
MARIETTA EYE CLINIC, PA
NPI
1013079375
Phone
(770) 577-2220
Address
8841 HOSPITAL DR
Authorized Official
HENRY ELLIOTT GATEHOUSE SENIOR DIRECTOR
Enumeration Date
14 December 2006
Last Update Date
15 May 2018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:19State licenses:0Digital endpointsOther names

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Provider Addresses for MARIETTA EYE CLINIC, PA

  • 8841, Hospital Drive, Anneewakee Heights, Douglasville, Douglas County, Georgia, 30134, United States

    DOUGLASVILLE, GA 30134

    Phone: (770) 577-2220

    Type: Location

  • 895, Canton Road Northeast, Elizabeth, Marietta, Cobb, Georgia, 30060, United States

    BUILDING 100

    MARIETTA, GA 300608934

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040518000057OClinic/Group PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30134)

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Reviews

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Frequently asked questions

What unique ID ties claims to MARIETTA EYE CLINIC, PA?
NPI 1013079375 is assigned to MARIETTA EYE CLINIC, PA under the national enumeration system.
Is MARIETTA EYE CLINIC, PA's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MARIETTA EYE CLINIC, PA's specialty in plain language?
Clinically, the directory lists MARIETTA EYE CLINIC, PA with Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Does MARIETTA EYE CLINIC, PA practice in Georgia?
You will see Douglasville, Georgia on file for MARIETTA EYE CLINIC, PA alongside any extra practice locations.
What if Douglasville, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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