Individual provider Active NPI

Kasarachi C Ihedoro, OD

  • Optometrist
  • Brandon, FL
National Provider Identifier
1003594706
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6297 Issued in FL
Practice address
307 Brandon Town Center Mall
Brandon, FL 33511-4723
Phone
(813) 684-0815
Fax
(813) 869-3830
NPI assigned
Jul 11, 2023
Last updated
Sep 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6297 FL Primary

Addresses

Primary practice location

307 Brandon Town Center Mall
Brandon, FL 33511-4723

Mailing address

307 Brandon Town Center Mall
Brandon, FL 33511-4723
Phone (813) 684-0815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726000908 FL Practitioner - Optometry 7315308194 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6297FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Eyecare Centers PLLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Sightrite Medical FL PLLC Optometrist CurrentSince Mar 1, 2025 Accepting new patients

Locations

2416 W Brandon Blvd
Brandon, FL 33511
Phone (813) 684-7070

1929 W Brandon Blvd
Brandon, FL 33511
Phone (813) 684-7071

307 Brandon Town Center Mall
Brandon, FL 33511
Phone (813) 684-0815

575 Lamar Ave
Brooksville, FL 34601
Phone (352) 799-2226

17781 Thelma Ave
Jupiter, FL 33458
Phone (561) 746-2998

1800 NE 168th St
North Miami Beach, FL 33162
Phone (305) 917-1800

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

267 Broadway
Brooklyn, NY 11211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1003594706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BRANDON TOWN CENTER MALL",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114723",
            "telephone_number": "813-684-0815",
            "fax_number": "813-868-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BRANDON TOWN CENTER MALL",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114723",
            "telephone_number": "813-684-0815",
            "fax_number": "813-869-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEDORO",
        "first_name": "KASARACHI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.