Organization Active NPI

William J Oktavec MD PA

  • Ophthalmology Physician
  • St Augustine, FL
National Provider Identifier
1053504415
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0046211 Issued in FL
Legal business name
WILLIAM J OKTAVEC MD PA
Practice address
100 Whetstone PL
Suite 106
St Augustine, FL 32086-5774
Phone
(904) 826-3937
Fax
(904) 826-3977
NPI assigned
Aug 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Dr. William J Oktavec, M.DNPI 1962448670
Title
Ceo, Owner
Phone
(904) 826-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X ME0046211 FL Primary

Addresses

Primary practice location

100 Whetstone PL
Suite 106
St Augustine, FL 32086-5774

Mailing address

100 Whetstone PL
Suite 106
St Augustine, FL 32086-5774
Phone (904) 826-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071003000352 FL Part B Supplier - Clinic/Group Practice 1153416359 Receives reassigned benefits from 2 practitioners
Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Locations

100 Whetstone Pl
Ste 106
St Augustine, FL 32086
Phone (904) 826-3937

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1053504415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL",
            "address_2": "SUITE 106",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865774",
            "telephone_number": "904-826-3937",
            "fax_number": "904-826-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL",
            "address_2": "SUITE 106",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865774",
            "telephone_number": "904-826-3937",
            "fax_number": "904-826-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J OKTAVEC MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "OKTAVEC",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "904-826-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0046211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.