Active NPI
Andrew David Burtchell, O.D.
- Optometrist
- Pace, FL
National Provider Identifier
1053862227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC5293
- Practice address
- 4954 Highway 90
Pace, FL 32571-1413 - Phone
- (850) 910-4840
- NPI assigned
- Oct 21, 2016
- Last updated
- Dec 11, 2019
- 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 | OPC5293 | FL | Primary |
Addresses
Primary practice location
4954 Highway 90
Pace, FL 32571-1413
Mailing address
4954 Highway 90
Pace, FL 32571-1413
Phone (850) 910-4840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC5293 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Opticlub Express, Inc. | Optometrist | Current | Accepting new patients |
Locations
4954 Highway 90
Pace, FL 32571
Phone (850) 910-4840
Organizations & group practices 1
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": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1053862227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4954 HIGHWAY 90",
"city": "PACE",
"state": "FL",
"postal_code": "325711413",
"telephone_number": "850-910-4840",
"fax_number": "850-254-2970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4954 HIGHWAY 90",
"city": "PACE",
"state": "FL",
"postal_code": "325711413",
"telephone_number": "850-910-4840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURTCHELL",
"first_name": "ANDREW",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-21",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC5293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.