Individual provider Active NPI

Laurie Naheel Bateh, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1053895060
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5594 Issued in FL
Practice address
1233 Lane Ave S Ste 31
Jacksonville, FL 32205-6254
Phone
(904) 309-3299
NPI assigned
Sep 17, 2018
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5594 FL Primary

Addresses

Primary practice location

1233 Lane Ave S Ste 31
Jacksonville, FL 32205-6254

Mailing address

1233 Lane Ave S Ste 31
Jacksonville, FL 32205-6254
Phone (904) 309-3299

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
I20181130000915 FL Practitioner - Optometry 0941544076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman S Bateh O D P aGroup PAC ID 5496912792, 2 clinicians

Practice addresses (Care Compare)

1233 Lane Ave S
Suite 15
Jacksonville, FL 32205-6254
Phone (904) 781-6770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Norman S Bateh O D P a Optometrist CurrentSince Sep 22, 2018 Accepting new patients

Locations

1233 Lane Ave S
Ste 15
Jacksonville, FL 32205
Phone (404) 734-1780

1233 Lane Ave S
Ste 31
Jacksonville, FL 32205
Phone (904) 781-6770

5162 Norwood Ave
Jacksonville, FL 32208
Phone (904) 764-2591

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": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1053895060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 LANE AVE S STE 31",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056254",
            "telephone_number": "904-309-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 LANE AVE S STE 31",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056254",
            "telephone_number": "904-309-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEH",
        "first_name": "LAURIE",
        "middle_name": "NAHEEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.