Individual provider Active NPI

William D Reynolds, M.D.

  • Ophthalmology Physician
  • Tampa, FL
National Provider Identifier
1114919974
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0051319 Issued in FL
Practice address
3000 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6308
Phone
(813) 877-2020
Fax
(813) 872-7387
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0051319 FL Primary

Addresses

Primary practice location

3000 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6308

Mailing address

3000 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6308
Phone (813) 877-2020

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101221000099 FL Practitioner - Ophthalmology 9830099571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Florida College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Eye Clinic and Associates PAGroup PAC ID 8123928868, 17 clinicians

Practice addresses (Care Compare)

3000 W ML King Jr Blvd
Tampa, FL 33607-6351
Phone (813) 877-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0051319FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Eye Clinic and Associates PA Ophthalmology CurrentSince Feb 13, 1999 Accepting new patients

Locations

1001 Dale Mabry Hwy
Lutz, FL 33548

3643 S Dale Mabry Hwy
Tampa, FL 33629
Phone (813) 321-1875

3000 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607
Phone (813) 877-2020

3000 W Mlk Blvd
Tampa, FL 33607
Phone (813) 877-2020

Interoperability endpoints

  • Direct secure messaging: william.reynolds.p1@direct.tec.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291680000000",
    "number": "1114919974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076308",
            "telephone_number": "813-877-2020",
            "fax_number": "813-872-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076308",
            "telephone_number": "813-877-2020",
            "fax_number": "813-872-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2010-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0051319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.