Premiermed Ophthalmology, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PREMIERMED OPHTHALMOLOGY, LLC

Practice address

1291 Winter Garden Vineland Rd Ste 130
Winter Garden, FL 34787-6705

Phone

(407) 501-7100

Fax

(407) 501-7200

NPI assigned

Dec 3, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Gary Visser, MDNPI 1710170568

Title

Managing Member

Phone

(407) 581-9065

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael P Imler, M.D.

  • Ophthalmology Physician
  • Winter Garden, FL
  • NPI 1760458939
  Medicare reassignment NPD
• Gary Visser, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Ocoee, FL
  • NPI 1710170568
  NPD Authorized official

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1154089332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 WINTER GARDEN VINELAND RD STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876705",
            "telephone_number": "407-501-7100",
            "fax_number": "407-501-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 WINTER GARDEN VINELAND RD STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876705",
            "telephone_number": "407-501-7100",
            "fax_number": "407-501-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERMED OPHTHALMOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "VISSER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "407-581-9065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sienna Pontone
• Caroline E. Poole, RBT
• Shannon Pope, MD
• Positive Strides LLC
• Premier Counseling LLC
• Prestige Total Health of Colorado LLC
• Prestige Total Health of Florida, PLLC
• Prestige Total Health of Nebraska, LLC
• Monica Prieto, CCHW
• Prime Dialysis, LLC

• Ophthalmology Physician in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.