Individual provider Active NPI

Suraj Sharma, OD

  • Optometrist
  • Orlando, FL
National Provider Identifier
1205674801
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6530 Issued in FL
Practice address
7939 S Orange Blossom TRL
Orlando, FL 32809-6909
Phone
(689) 206-8882
NPI assigned
Jul 17, 2024
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6530 FL Primary

Addresses

Primary practice location

7939 S Orange Blossom TRL
Orlando, FL 32809-6909

Mailing address

7939 S Orange Blossom TRL
Orlando, FL 32809-6909

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
I20250304001554 FL Practitioner - Optometry 8022539394 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6530FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Deal Optical LLC Optometrist CurrentSince Mar 1, 2025 Accepting new patients
National Vision Inc Optometrist CurrentSince Jul 21, 2024 Accepting new patients
Jimmy Nguyen OD PA Optometrist PastSince Mar 1, 2025 Accepting new patients

Locations

1204 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 408-5177

7939 S Orange Blossom Trl
Orlando, FL 32809
Phone (689) 206-8882

Organizations & group practices 4

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": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1205674801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7939 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328096909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7939 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328096909",
            "telephone_number": "689-206-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SURAJ",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.