Individual provider Active NPI

Anthony T Huynh, OD, FAAO

  • Pediatric Optometrist
  • Orlando, FL
National Provider Identifier
1043575228
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
4783 Issued in FL
Practice address
567 S Chickasaw TRL
Orlando, FL 32825
Phone
(407) 930-5566
Fax
(321) 549-6242
NPI assigned
Jul 12, 2012
Last updated
Sep 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7991TG TX
Optometrist 152W00000X 4783 FL
Corneal and Contact Management Optometrist 152WC0802X 4783 FL
Low Vision Rehabilitation Optometrist 152WL0500X 4783 FL
Pediatric Optometrist 152WP0200X 4783 FL Primary

Addresses

Primary practice location

567 S Chickasaw TRL
Orlando, FL 32825

Mailing address

567 S Chickasaw TRL
Orlando, FL 32825-7801
Phone (407) 930-5566

Other identifiers 1

IdentifierTypeStateIssuer
1124091-04MedicaidTX

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
I20131210000746 FL Practitioner - Optometry 2466600390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 Neighborhood Market Rd
Suite 105
Orlando, FL 32825-3525
Phone (407) 930-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7991TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Macali Eye Clinic, PA Optometrist CurrentSince Feb 1, 2016 Accepting new patients
HD Eyecare Corporation Optometrist CurrentSince Dec 1, 2013 Accepting new patients
Peepers Eyecare Inc Past Accepting new patients

Locations

222 Neighborhood Market Rd
Ste 105
Orlando, FL 32825
Phone (407) 930-5566

567 S Chickasaw Trl
Orlando, FL 32825
Phone (407) 281-0866

2478 Burnsed Blvd
#466A
The Villages, FL 32163
Phone (352) 399-5412

1155 Winter Garden Vineland Rd
Ste 102
Winter Garden, FL 34787
Phone (407) 656-3755

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, 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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1043575228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 S CHICKASAW TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328257801",
            "telephone_number": "407-930-5566",
            "fax_number": "321-549-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 S CHICKASAW TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32825",
            "telephone_number": "407-930-5566",
            "fax_number": "321-549-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "ANTHONY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7991TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4783",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "4783",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "4783",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "4783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124091-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.