Provider Demographics
NPI:1932125564
Name:GROAT EYECARE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:GROAT EYECARE ASSOCIATES, P.A.
Other - Org Name:ROBERT L. GROAT, M.D., P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LANIER
Authorized Official - Last Name:GROAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-378-1442
Mailing Address - Street 1:1317 N ELM ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1033
Mailing Address - Country:US
Mailing Address - Phone:336-378-1442
Mailing Address - Fax:336-378-1970
Practice Address - Street 1:1317 N ELM ST
Practice Address - Street 2:SUITE 4
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1033
Practice Address - Country:US
Practice Address - Phone:336-378-1442
Practice Address - Fax:336-378-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC623OtherPARTNERS
NC89011FJMedicaid
NC011FJOtherBLUE CROSS BLUE SHIELD
NC2344616Medicare ID - Type Unspecified
NCCH3330Medicare ID - Type UnspecifiedRAILROAD (PALMETTO GBA)
NC4240600001Medicare NSC
NC623OtherPARTNERS