NPIMap

Organization Active NPI

Newsom Eye & Laser Center, Inc.

  • Ophthalmology Physician
  • Sebring, FL
National Provider Identifier
1104206994
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NEWSOM EYE & LASER CENTER, INC.
Practice address
4211 US Highway 27 N
Sebring, FL 33870
Phone
(863) 385-1544
Fax
(863) 385-1233
NPI assigned
Jun 5, 2015
Last updated
Jan 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Authorized official

Name
Thomas Hunter Newsom, M.D.NPI 1851386395
Title
President
Phone
(863) 385-1544

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X FL
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X FL Primary

Addresses

Primary practice location

4211 US Highway 27 N
Sebring, FL 33870

Mailing address

13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Phone (813) 908-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151030001139 FL DME Supplier - Physician - OptometristDME Supplier - Physician - General PracticeDME Supplier - Physician - Ophthalmology 0648241190 Practice locations: Sebring, FL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2099618Newsom Eye and Laser Center Inc4211 US Hwy 27 N, Sebring, FL 33870Certificate of waiverJul 29, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Newsom Eye & Laser Center Inc4211 US Highway 27 N, Sebring, FL 33870-1917(863) 385-1544 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Newsom Eye Laser Center I7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1104206994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 US HIGHWAY 27 N",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-385-1544",
            "fax_number": "863-385-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWSOM EYE & LASER CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "NEWSOM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-385-1544",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.