Active NPI
Jeffrey P Krill, OD
- Optometrist
- St Petersburg, FL
National Provider Identifier
1154401438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- FLOP2068
- Practice address
- 2300 N Tyrone Blvd
Co Sears Optical
St Petersburg, FL 33710 - Phone
- (727) 341-7297
- Fax
- (727) 347-0937
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | FLOP2068 | FL | Primary |
Addresses
Primary practice location
2300 N Tyrone Blvd
Co Sears Optical
St Petersburg, FL 33710
Mailing address
2300 N Tyrone Blvd
Co Sears Optical
St Petersburg, FL 33710
Phone (727) 341-7297
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120222000162 | FL | Practitioner - Optometry | 8527226596 | Practice locations: Bradenton, FL; Sarasota, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1985
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
300 N Cattlemen Rd
Sams' Club Optical
Sarasota, FL 34232-6426
Phone (941) 341-0737
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FLOP2068 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients |
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.
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- NPI 1023164886
-
- Eyewear Supplier
- Fort Meyers, FL
- NPI 1477607521
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154401438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 N TYRONE BLVD",
"address_2": "CO SEARS OPTICAL",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33710",
"telephone_number": "727-341-7297",
"fax_number": "727-347-0937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 N TYRONE BLVD",
"address_2": "CO SEARS OPTICAL",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33710",
"telephone_number": "727-341-7297",
"fax_number": "727-347-0937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRILL",
"first_name": "JEFFREY",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "FLOP2068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.