Avalon Park Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3836 Issued in FL

Legal business name

AVALON PARK EYE CARE, LLC

Practice address

12001 Avalon Lake Dr
Suite J
Orlando, FL 32828-7375

Phone

(407) 567-9955

Fax

(407) 567-9966

NPI assigned

Jun 14, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth John Tesinsky, O.D.NPI 1649312513

Title

President/Optometrist

Phone

(407) 567-9955

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Kenneth John Tesinsky, O.D.

  • Optometrist
  • Orlando, FL
  • NPI 1649312513
  Medicare reassignment Care Compare group NPD Authorized official
• Cecilia Wong Tesinsky, O.D.

  • Optometrist
  • Orlando, FL
  • NPI 1982710273
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1244937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1053548313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 AVALON LAKE DR",
            "address_2": "SUITE J",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287375",
            "telephone_number": "407-567-9955",
            "fax_number": "407-567-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 AVALON LAKE DR",
            "address_2": "SUITE J",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287375",
            "telephone_number": "407-567-9955",
            "fax_number": "407-567-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PARK EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-14",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "TESINSKY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "407-567-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Avalon SH Management

• Optometrist in Orlando, FL
• Providers in Orlando, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.