Individual provider Active NPI

Dakota Rhea Lewis, OD

  • Optometrist
  • Brandon, FL
National Provider Identifier
1124597307
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5607 Issued in FL
Practice address
883 E Bloomingdale Ave
Brandon, FL 33511-8113
Phone
(813) 661-1930
NPI assigned
Nov 18, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5607 FL Primary

Addresses

Primary practice location

883 E Bloomingdale Ave
Brandon, FL 33511-8113

Mailing address

2907 Laurel Meadow CT
Plant City, FL 33566-0386
Phone (813) 895-9389

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
I20190125001340 FL Practitioner - Optometry 5496092678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

883 E Bloomingdale Ave
Brandon, FL 33511-8113
Phone (813) 661-1930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5607FLMDOptometrist

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients
Eye Doctors Optical Outlets, PA Optometrist CurrentSince Nov 28, 2018 Accepting new patients

Locations

937 Brandon Town Center Mall
Brandon, FL 33511
Phone (813) 685-1935

883 E Bloomingdale Ave
Brandon, FL 33511
Phone (813) 661-1930

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

1510 E Fowler Ave
Tampa, FL 33612
Phone (813) 971-0471

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1542499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1124597307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 LAUREL MEADOW CT",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335660386",
            "telephone_number": "813-895-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 E BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118113",
            "telephone_number": "813-661-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DAKOTA",
        "middle_name": "RHEA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-18",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.