MEDICARE: EXCEL EYECARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396592382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEL EYECARE, LLC

Provider Business Mailing Address
First Line	:	236 BARRINGTON CIR
Second Line	:
City	:	ALEXANDRIA
State	:	AL
Zip	:	36250-7205
Country	:	US
Telephone Number	:	256-452-1572
Fax Number	:	256-546-1094

Provider Business Practice Location Address
First Line	:	200 WHITEMAN AVE
Second Line	:
City	:	ELKINS
State	:	WV
Zip	:	26241-3400
Country	:	US
Telephone Number	:	615-728-1441
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. JAY MICHAEL JOHNSON
Credential	:	OD
Telephone Number	:	256-452-1572

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	02/03/2026

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Directions to “EXCEL EYECARE, LLC ” Practice Location

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