DR. WILLIAM A SEGAL M.D.
NPI 1275698516
Ophthalmology in Duluth, GA


Quality Rating: 92.27 out of 100 score

NPI Status: Active since December 27, 2006

Contact Information

3800 PLEASANT HILL RD
SUITE 3
DULUTH, GA
ZIP 30096
Phone: (678) 584-0400
Fax: (678) 584-0568

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  • Individual
  • Male
  • Years of Experience 30
  • Ophthalmology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting
  • CLIA Number: 11D2054579
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-24-2025

About WILLIAM SEGAL

This page provides the complete NPI Profile along with additional information for William Segal, a provider established in Duluth, Georgia with a medical specialization in Ophthalmology and more than 30 years of experience. He graduated from Emory University School Of Medicine in 1996. The healthcare provider is registered in the NPI registry with number 1275698516 assigned on December 2006. The practitioner's primary taxonomy code is 207W00000X with license number 050261 (GA). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1275698516
Provider Name
DR. WILLIAM A SEGAL M.D.
Gender
Male
Entity Type
Individual
Location Address
3800 PLEASANT HILL RD SUITE 3 DULUTH, GA 30096
Location Phone
(678) 584-0400
Location Fax
(678) 584-0568
Mailing Address
3800 PLEASANT HILL RD SUITE 3 DULUTH, GA 30096
Mailing Phone
(678) 584-0400
Mailing Fax
(678) 584-0568
Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1996
Is Sole Proprietor?
No
Enumeration Date
12-27-2006
Last Update Date
10-31-2019
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Ophthalmologists like William Segal 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.

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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
License No.
050261
License State
GA
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)
1207W00000XAllopathic & Osteopathic Physicians

Ophthalmology

50261 (GA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Silver - HMO
  • Elite Silver + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Complete Silver with Atrium Health - HMO
  • Complete Silver with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Blue Choice Preferred Bronze PPO? 201 - PPO
  • Blue Choice Preferred Bronze PPO? 701 - PPO
  • Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
  • Blue Choice Preferred Gold PPO? 204 - PPO
  • Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
  • Blue Choice Preferred Security PPO? 200 - PPO
  • Blue Choice Preferred Silver PPO? 203 - PPO
  • Blue Choice Preferred Silver PPO? 801 - PPO
  • Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
  • Blue Precision Bronze HMO? 205 - HMO
  • Blue Precision Bronze HMO? 701 - HMO
  • Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
  • Blue Precision Gold HMO? 207 - HMO
  • Blue Precision Gold HMO? 703 - HMO
  • Blue Precision Gold HMO? Standard - Rx Copays - HMO
  • Blue Precision Silver HMO? 206 - HMO
  • Blue Precision Silver HMO? 704 - HMO
  • Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
  • BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate - HMO
  • BlueCare Direct Gold? Standard - Rx Copays with Advocate - HMO
  • Blue Focus Bronze POS? 205 - POS
  • Blue Focus Bronze POS? 705 - POS
  • Blue Focus Bronze POS? Standard - POS
  • Blue Focus Gold POS? 207 - POS
  • Blue Focus Gold POS? Standard - POS
  • Blue Focus Silver POS? 206 - POS
  • Blue Focus Silver POS? Standard - POS
  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • MyBlue Gold HMO? 704 - HMO
  • MyBlue Gold HMO? 804 - HMO
  • MyBlue Gold HMO? Standard - HMO
  • MyBlue Silver HMO? 705 - HMO
  • MyBlue Silver HMO? 803 - HMO
  • MyBlue Silver HMO? Standard - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Deductible Silver 4500 $3 Generic Drugs - HMO
  • Low Deductible Silver 4500 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs - HMO
  • Low Premium Bronze 9200 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Standard Expanded Bronze WellCare - PPO
  • Standard Gold WellCare - PPO
  • Standard Silver WellCare - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

William Segal is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

William Segal is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 547201113

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20101005000113

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Unknown

  • Other-Vision, Hearing, and Speech Services (OC000N)

    Frames, purchases (HCPCS:V2020)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Cataract surgery

Cataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.

This service was performed for 377 patients

Closure of tear duct opening using plug

Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.

This service was performed 86 times for 73 patients

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 20 times for 17 patients

Ct scan of cornea

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

This service was performed 73 times for 60 patients

Destruction of lens tissue using laser

Destruction of lens tissue using a laser is a medical procedure aimed at treating eye conditions like cataracts. A laser is employed to break down the affected lens tissue, which is then removed. This allows the insertion of an artificial lens to improve vision.

This service was performed 27 times for 20 patients

Established patient complete exam of visual system

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

This service was performed 670 times for 598 patients

Established patient problem focused exam of visual system

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

This service was performed 594 times for 458 patients

Exam of the internal drainage system of eye

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

This service was performed 78 times for 77 patients

Exam of visual field with extended testing

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

This service was performed 403 times for 400 patients

Exam of visual field with intermediate testing

An exam of the visual field with intermediate testing is a procedure that checks your peripheral (side) vision. It helps to identify blind spots which could be a sign of eye diseases. This non-invasive test is painless and quick.

This service was performed 22 times for 19 patients

Extended exam of the back part of the eye with retinal drawing

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

This service was performed 42 times for 37 patients

Imaging of optic nerve

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

This service was performed 291 times for 287 patients

Imaging of retina

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

This service was performed 327 times for 300 patients

Measurement of corneal curvature and depth of eye

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

This service was performed 274 times for 110 patients

New patient complete exam of visual system

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

This service was performed 52 times for 52 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 15 times for 15 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 29 times for 29 patients

Photography of content of eyes

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

This service was performed 15 times for 15 patients

Photography of the retina

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

This service was performed 628 times for 624 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 120 times for 74 patients

Removal of eyelashes using forceps

The removal of eyelashes using forceps is a simple procedure where a medical professional gently extracts unwanted or problematic eyelashes with a specialized tool. This is often done to alleviate discomfort or to treat conditions like trichiasis, where eyelashes grow inward.

This service was performed 115 times for 96 patients

Removal of foreign body from external eye (conjunctiva or sclera)

This procedure involves removing a foreign object from your eye's outer layers, the conjunctiva or sclera. It's done with specialized tools, ensuring the eye isn't damaged. You may feel slight discomfort, but it's usually quick and can prevent further eye complications.

This service was performed 17 times for 16 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 14 times for 14 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 120 times for 78 patients

Ultrasound scan of cornea to determine thickness

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

This service was performed 32 times for 32 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.66 for a new patient copayment and $17.71 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30096 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.64
  • Minimum New Patient Price $56.84
  • Maximum New Patient Price $172.43
  • Average New Patient Copayment $32.66
  • Minimum New Patient Copayment $14.21
  • Maximum New Patient Copayment $43.1

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.85
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $140.4
  • Average Established Patient Copayment $17.71
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $35.1

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.27, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 92.27 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 76.1

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 94.21

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. William Segal is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTHSIDE HOSPITAL1000 JOHNSON FERRY ROAD, NE
ATLANTA, GA 30342
(404) 851-8000Acute Care Hospitals

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
11D2054579
Facility Type
Physician Office
Certificate Effective Date
February 25, 2023
Certificate Expiration Date
February 24, 2025
Laboratory Director
DR. WILLIAM A. SEGAL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to William Segal 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 Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1275698516
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221451291652
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 4 + 5 + 1 + 2 + 9 + 1 + 6 + 5 + 2 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1275698516 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1366577900MRS. SONYA W WRIGHT MPT
Individual
Physical Therapist3800 PLEASANT HILL RD SUITE 3
DULUTH, GA 30096
(678) 473-7707
1164555405 ROBERT DAVIS GRACE D.C.
Individual
Chiropractor3800 PLEASANT HILL RD SUITE 3
DULUTH, GA 30096
(770) 497-9700
1497060362DR. MARC K LAY O.D.
Individual
Optometrist3800 PLEASANT HILL RD
DULUTH, GA 30096
(770) 630-4625
1558547968 SHIRLEY Z YOUNG MD
Individual
Family Medicine3800 PLEASANT HILL RD SUITE 5
DULUTH, GA 30096
(770) 622-2566
1346428372BERKELEY FAMILY MEDICINE ASSOCIATES, LLC
Organization
Family Medicine3800 PLEASANT HILL RD SUITE 5
DULUTH, GA 30096
(770) 622-2566

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275698516, enumerated in the NPI registry as an "individual" on December 27, 2006

The provider is located at 3800 Pleasant Hill Rd Suite 3 Duluth, Ga 30096 and the phone number is (678) 584-0400

The provider's speciality is Ophthalmology with taxonomy code 207W00000X

The provider has more than 30 years of experience. He graduated from Emory University School Of Medicine in 1996.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter from. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $130.64 with an average copayment of $32.66 for new patient appointments. Established patients should expect a typical charge of $70.85 and an average copayment of 17.71. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Cataract surgery, Closure of tear duct opening using plug, Complex removal of cataract with insertion of prosthetic lens, Ct scan of cornea, Destruction of lens tissue using laser, Established patient complete exam of visual system, Established patient problem focused exam of visual system, Exam of the internal drainage system of eye, Exam of visual field with extended testing, Exam of visual field with intermediate testing, Extended exam of the back part of the eye with retinal drawing, Imaging of optic nerve, Imaging of retina, Measurement of corneal curvature and depth of eye, New patient complete exam of visual system, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes, Photography of content of eyes, Photography of the retina, Removal of cataract with insertion of prosthetic lens, Removal of eyelashes using forceps, Removal of foreign body from external eye (conjunctiva or sclera), Removal of recurring cataract in lens capsule using a laser, Removal of recurring cataract in lens capsule using a laser and Ultrasound scan of cornea to determine thickness.

The provider's CLIA number is 11D2054579 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..

The practitioner is affiliated to the following hospital(s): NORTHSIDE HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on December 27, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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