MEDICARE: DR. AUSTIN JAMES DEGROFF OD

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	030.0134023	VT
2	152W00000X	Optometrist	2873	NC

General Provider Information

NPI Number	:	1487451217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUSTIN JAMES DEGROFF OD

Provider Business Mailing Address
First Line	:	1729 NEW HANOVER MEDICAL PARK DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-5345
Country	:	US
Telephone Number	:	910-763-3601
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 US HIGHWAY 117 S
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-6704
Country	:	US
Telephone Number	:	910-736-3601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	09/25/2025

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