Individual provider Active NPI

Robert E Luckey Jr., O.D.

  • Optometrist
  • Wesley Chapel, FL
National Provider Identifier
1184744104
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3815 Issued in FL
Practice address
2306 Greenbranch Dr
Suite #102
Wesley Chapel, FL 33544
Phone
(813) 866-4004
Fax
(813) 866-4005
NPI assigned
Mar 31, 2007
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3815 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OPC 3815 FL

Addresses

Primary practice location

2306 Greenbranch Dr
Suite #102
Wesley Chapel, FL 33544

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
620881900MedicaidFL

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
I20040610000273 FL Practitioner - Optometry 4486637907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

2140 Crawfordville Hwy
Crawfordville, FL 32327-1009
Phone (850) 926-9213

2306 Greenbranch Dr
Suite 102
Wesley Chapel, FL 33544-6796
Phone (813) 866-4004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3815FLMDOptometrist
OPC 3815FLMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Oct 23, 2022 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Dec 1, 2022 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Dec 1, 2022 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Past Accepting new patients

Locations

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

2306 Greenbranch Dr
Ste 102
Wesley Chapel, FL 33544
Phone (813) 866-4004

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: rluckey027616@myeyedr.emadirect.md

Organizations & group practices 7

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": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1184744104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 GREENBRANCH DR",
            "address_2": "SUITE #102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33544",
            "telephone_number": "813-866-4004",
            "fax_number": "813-866-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-31",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3815",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC 3815",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620881900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.