Individual provider Active NPI

Nataliya A Yakovleva, OD

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1164872230
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5194 Issued in FL
Practice address
7840 Gate Pkwy
Jacksonville, FL 32256-7277
Phone
(904) 503-4801
Fax
(904) 503-7153
NPI assigned
Jun 20, 2016
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5194 FL Primary

Addresses

Primary practice location

7840 Gate Pkwy
Jacksonville, FL 32256-7277

Mailing address

7840 Gate Pkwy
Jacksonville, FL 32256-7277
Phone (904) 503-4108

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
I20171220001022 FL Practitioner - Optometry 0143588194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern Univ College of Dental Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7840 Gate Pkwy
Jacksonville, FL 32256-7277
Phone (904) 503-4797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5194FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Inoptix Eyecare Center PA Optometrist CurrentSince Aug 1, 2021 Accepting new patients

Locations

7840 Gate Pkwy
Jacksonville, FL 32256
Phone (904) 503-4797

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1164872230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7840 GATE PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567277",
            "telephone_number": "904-503-4108",
            "fax_number": "904-035-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 GATE PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567277",
            "telephone_number": "904-503-4801",
            "fax_number": "904-503-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKOVLEVA",
        "first_name": "NATALIYA",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.