Individual provider Active NPI

Jeffrey P Krill, OD

  • Optometrist
  • St Petersburg, FL
National Provider Identifier
1154401438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FLOP2068 Issued in FL
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
FLOP2068FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.