Sushma K Vance, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME122617 Issued in FL

Practice address

6207 Bennett Rd
Jacksonville, FL 32216-5007

Phone

(904) 241-7865

NPI assigned

Aug 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Sushma Kandula Former name

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

Specialty

Ophthalmology

Education

Northeastern Ohio University College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantic Eye Institute, P.a.Group PAC ID 2466434386, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Atlantic Eye Institute, P.a.

  • Ophthalmology Physician
  • Jacksonville Beach, FL
  • NPI 1033200241
  Medicare reassignment Care Compare group NPD
• Harris Wilcox and Donovan PA

  • Ophthalmology Physician
  • Orange Park, FL
  • NPI 1023120409
  Medicare reassignment NPD
• Atlantic Eye Institute P.a.

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1376685404

  Ophthalmology

  NPD
• Harris Wilcox and Donovan P a

  • Ophthalmology Physician
  • Fleming Island, FL
  • NPI 1710019435
  NPD
• Harris Wilcox and Donovan PA

  • Ophthalmology Physician
  • Middleburg, FL
  • NPI 1659963205
  NPD
• Retina Consultants of Houston PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Beaumont, TX
  • NPI 1720758709
  NPD (past)
• Retina Consultants of Houston PLLC

  • Ophthalmology Physician
  • Pearland, TX
  • NPI 1780294629
  NPD (past)
• Retina Consultants of Houston PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Bellaire, TX
  • NPI 1902975352
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1124210281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 BENNETT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165007",
            "telephone_number": "941-241-7865",
            "fax_number": "407-470-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6207 BENNETT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165007",
            "telephone_number": "904-241-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "SUSHMA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME122617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014425300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE",
            "identifier": "ME122617",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSHMA",
            "last_name": "KANDULA",
            "prefix": "MS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Long Van, D.C.
• Tim T. Van, DMD
• Alexandra Chiu Vance, PHARMD, BCPS
• Danielle P Vance, O.D.
• Kimberly Sue Vance
• William Vance
• Jill L Vancil
• Chelsea Blythe Vandenbroek, PT, DPT
• Micah Aaron Vander Griend, MD, MPH
• Clare M Vander Sluis, APRN

• Ophthalmology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.