Active NPI
Edward Attaway, O.D.
- Optometrist
- Winter Haven, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 2010
- Practice address
- 407 Avenue K SE
Winter Haven, FL 33880-4126 - Phone
- (863) 294-3504
- Fax
- (863) 294-8305
- NPI assigned
- Jun 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 2010 | FL | Primary |
Addresses
Primary practice location
407 Avenue K SE
Winter Haven, FL 33880-4126
Mailing address
407 Avenue K SE
Winter Haven, FL 33880-4126
Phone (863) 294-3504
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078605500 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
407 Ave K SE
Winter Haven, FL 33880-4126
Phone 86329435041280
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 2010 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Specialists of Mid Florida, PA | Current | Accepting new patients | |
| Eye Specialists of Mid Florida PA | Optometrist | Current | Accepting new patients |
| Eye Specialists of Mid Florida, PA | Past | Accepting new patients |
Locations
202 Magnolia Ave
Auburndale, FL 33823
Phone (863) 294-3504
1050 US Highway 27
Ste 1
Clermont, FL 34714
Phone (352) 394-8705
100 Patterson Rd
Haines City, FL 33844
Phone (863) 294-3504
2800 Ridge Way
Ste 100
Lake Wales, FL 33859
Phone (863) 676-2008
3350 Harden Blvd
Lakeland, FL 33803
Phone (863) 294-3504
2004 E County Road 540A
Lakeland, FL 33813
Phone (863) 294-3504
5032 US 27 N
Sebring, FL 33870
Phone (863) 382-3900
407 Avenue K SE
Winter Haven, FL 33880
Phone (863) 294-3504
Interoperability endpoints
- edward.attaway@esmf.direct.eyemdemr.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ophthalmology Physician
- Winter Haven, FL
- NPI 1366437162
Optometrist
-
- Health Service Clinic/Center
- Auburndale, FL
- NPI 1700370616
-
- Ophthalmology Physician
- Sebring, FL
- NPI 1487980967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265673600000",
"number": "1003810367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 AVENUE K SE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338804126",
"telephone_number": "863-294-3504",
"fax_number": "863-294-8305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 AVENUE K SE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338804126",
"telephone_number": "863-294-3504",
"fax_number": "863-294-8305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATTAWAY",
"first_name": "EDWARD",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-02",
"last_updated": "2010-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 2010",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "078605500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.