Individual provider Active NPI

Alyssa Perlman-Hensen, O.D.

  • Optometrist
  • Daytona Beach, FL
National Provider Identifier
1154842961
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CPC5617 Issued in FL
Practice address
1900 Mason Ave Suite 100
Daytona Beach, FL 32117
Phone
(386) 274-5525
Fax
(803) 434-1581
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2034 SC
Optometrist 152W00000X 5214 MA
Corneal and Contact Management Optometrist 152WC0802X 5214 MA
Optometrist 152W00000X CPC5617 FL Primary

Addresses

Primary practice location

1900 Mason Ave Suite 100
Daytona Beach, FL 32117

Mailing address

1900 Mason Ave Suite 100
Daytona Beach, FL 32117
Phone (386) 274-5525

Other identifiers 2

IdentifierTypeStateIssuer
110772100MedicaidFL
D20341MedicaidSC

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
I20210526001764 FL Practitioner - Optometry 6901163757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.04 of 100Reported as group
Quality
97.77
Improvement activities
40
Cost
53.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CPC5617FLMDOptometrist
5214MAMDCorneal and Contact Management Optometrist
2034SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Filutowski Eye Institute PA Current Accepting new patients
Filutowski Eye Institute PA CurrentSince Jun 20, 2022 Accepting new patients
Filutowski Eye Institute PA CurrentSince Jun 20, 2022 Accepting new patients
Vision One Inc Optometrist Past Accepting new patients
F Mason Smith Optometrist Past Accepting new patients
Vision One Inc Optometrist PastSince Jun 23, 2021 Accepting new patients

Locations

110 Yorktowne Dr
Daytona Beach, FL 32119
Phone (386) 788-6696

1070 Greenwood Blvd
Lake Mary, FL 32746
Phone (407) 333-1537

2295 S Hiawassee Rd
Ste 101
Orlando, FL 32835
Phone (407) 902-2533

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: alyssa.perlmanhensen.p3@direct.fcli.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1154842961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MASON AVE SUITE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-274-5525",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MASON AVE SUITE 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "386-274-5525",
            "fax_number": "803-434-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLMAN-HENSEN",
        "first_name": "ALYSSA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2034",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5214",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MA",
            "license": "5214",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "CPC5617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110772100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D20341",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.