Benjamin John Konynenbelt, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5272 Issued in FL

Practice address

19527 Highland Oaks Dr Ste 203
Estero, FL 33928-9637

Phone

(239) 317-8200

NPI assigned

Jul 6, 2015

Reactivated

Nov 27, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edison Eye Care PLLCGroup PAC ID 4688039514, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Edison Eye Care, PLLC

  • Optometrist
  • Estero, FL
  • NPI 1255055646
  Medicare reassignment Care Compare group NPD Authorized official
• Gulf Coast Optometry, PA

  • Corneal and Contact Management Optometrist
  • Tampa, FL
  • NPI 1083859409
  Medicare reassignment NPD
• Southwest Orlando Eye Care LLC

  • Optometrist
  • Orlando, FL
  • NPI 1295163657
  Medicare reassignment NPD
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Perry, FL
  • NPI 1437537529
  NPD (past)
• National Vision, Inc.

  • Eyewear Supplier
  • Altamonte Springs, FL
  • NPI 1023164886
  NPD (past)

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1114300472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19527 HIGHLAND OAKS DR STE 203",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339289637",
            "telephone_number": "239-317-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19527 HIGHLAND OAKS DR STE 203",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339289637",
            "telephone_number": "239-317-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONYNENBELT",
        "first_name": "BENJAMIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "deactivation_date": "2024-11-20",
        "reactivation_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunika Klisiewicz, A.P.,D.O.M
• Sebastian Klisiewicz, D.O.
• Steven Lee Knepper, DDS
• Konowal Vision Inc
• Alexandra Konowal, DO
• Jessie Elizabeth Konynenbelt, O.D.
• Judie Lee Krupp, MACCC/SLP
• Charles J Kull, PT, DPT
• Josephine Marie Kunkle, PH.D
• Elizabeth Melissa Kwiatek

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.