Luc Emmanuel Kanicky, O.D.

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

OPC 003906 Issued in FL

Practice address

6911 Pistol Range Rd
Suite 103B
Tampa, FL 33635-6335

Phone

(813) 925-3393

Fax

(813) 925-3394

NPI assigned

Apr 20, 2006

Last updated

May 6, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bayside Family Eyecare

  • Optometrist
  • Tampa, FL
  • NPI 1942432935
  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1043275175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 PISTOL RANGE RD",
            "address_2": "SUITE 103B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336356335",
            "telephone_number": "813-925-3393",
            "fax_number": "813-925-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 PISTOL RANGE RD",
            "address_2": "SUITE 103B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336356335",
            "telephone_number": "813-925-3393",
            "fax_number": "813-925-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANICKY",
        "first_name": "LUC",
        "middle_name": "EMMANUEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC 003906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OPC  003906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Kanfer, M.D.
• Byoung Kwon Kang, APRN
• Loveleen Kang, MD
• Alicia S Kanhai, DPM
• Michele Leigh Kaniarz
• Colleen Kanies, UNDERGRADUATE
• Naveen Kumar Kannekanti, M.D.,
• Kirsty Greaves Kanner, PA
• Ankit Kansagra, M.D.
• Robert John Kanser, PH.D.

• Low Vision Rehabilitation Optometrist in Tampa, FL
• Providers in Tampa, FL by specialty
• Low Vision Rehabilitation Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.