Individual provider Active NPI

Joseph Collin Tegenkamp, OD

  • Optometrist
  • Pensacola, FL
National Provider Identifier
1093444648
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6071 Issued in FL
Practice address
6700 N Davis Hwy
Pensacola, FL 32504-6304
Phone
(850) 434-6387
Fax
(850) 432-0540
NPI assigned
Jun 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6071 FL Primary

Addresses

Primary practice location

6700 N Davis Hwy
Pensacola, FL 32504-6304

Mailing address

6700 N Davis Hwy
Pensacola, FL 32504-6304
Phone (850) 434-6387

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
I20221116000581 FL Practitioner - Optometry 7719355122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Eye Guy LLCGroup PAC ID 9931564184, 3 clinicians

Practice addresses (Care Compare)

6677 N Davis Hwy
Pensacola, FL 32504-6386
Phone (850) 434-6387

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6071FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Guy Associates of Florida LLC Optometrist CurrentSince Aug 5, 2022 Accepting new patients
My Eye Guy LLC Optometrist CurrentSince Jun 1, 2023 Accepting new patients

Locations

6700 N Davis Hwy
Pensacola, FL 32504
Phone (850) 434-4825

5328 N Davis Hwy
Pensacola, FL 32503
Phone (850) 434-6387

6677 N Davis Hwy
Pensacola, FL 32504
Phone (850) 434-6387

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1093444648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046304",
            "telephone_number": "850-434-6387",
            "fax_number": "850-432-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046304",
            "telephone_number": "850-434-6387",
            "fax_number": "850-432-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGENKAMP",
        "first_name": "JOSEPH",
        "middle_name": "COLLIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.