Samuel Adam Gruszka

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC6556 Issued in FL

Practice address

148 13TH St SW
Largo, FL 33770-3127

Phone

(813) 253-2727

NPI assigned

May 20, 2024

Sex

Male

Sole proprietor

Yes

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

University of Missouri St Louis - School of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Eye Physicians of Pinellas, PAGroup PAC ID 5092629071, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgruszka@directaddress.net

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.

• The Eye Physicians of Pinellas, PA

  • Ophthalmology Physician
  • Largo, FL
  • NPI 1114925153

  Optometrist

  Medicare reassignment Care Compare group NPD
• The Eye Physicians of Pinellas, PA

  • Durable Medical Equipment & Medical Supplies
  • Lakeland, FL
  • NPI 1790488013
  NPD
• The Eye Physicians of Pinellas, PA

  • Ambulatory Surgical Clinic/Center
  • Largo, FL
  • NPI 1366710741
  NPD (past)

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1134968167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646301",
            "telephone_number": "727-266-2393",
            "fax_number": "727-266-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 13TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703127",
            "telephone_number": "813-253-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Belcher Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337646301",
            "country_code": "US",
            "telephone_number": "727-266-2393",
            "fax_number": "727-266-2330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6133 Central Ave",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337108529",
            "country_code": "US",
            "telephone_number": "727-344-3008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11925 Sheldon Rd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336263644",
            "country_code": "US",
            "telephone_number": "813-792-0444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3220 N McMullen Booth Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612012",
            "country_code": "US",
            "telephone_number": "727-723-8706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Howard Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336061213",
            "country_code": "US",
            "telephone_number": "813-253-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUSZKA",
        "first_name": "SAMUEL",
        "middle_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Benjamin Jared Gubernick, D.D.S
• David Gubernick, MD
• Samuel Gubernick, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.