Individual provider Active NPI

Roy Z Braunstein, MD

  • Ophthalmology Physician
  • Lake Wales, FL
National Provider Identifier
1235328444
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME42087 Issued in FL
Practice address
749 State Road 60 E
Lake Wales, FL 33853-4240
Phone
(863) 676-7624
Fax
(863) 678-0263
NPI assigned
Oct 24, 2007
Last updated
May 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME42087 FL Primary

Addresses

Primary practice location

749 State Road 60 E
Lake Wales, FL 33853-4240

Mailing address

749 State Road 60 E
Lake Wales, FL 33853-4240
Phone (863) 676-7624

Other identifiers 1

IdentifierTypeStateIssuer
180020219OtherFLRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbraunstein@floridaeye.intellechartdirect.net

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080722000290 FL Practitioner - Ophthalmology 2163595372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
JS Weill Medical College, Cornell University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory L Henderson MD Facs IncGroup PAC ID 9739172321, 31 clinicians

Practice addresses (Care Compare)

403 Vonderburg Dr
Brandon, FL 33511-5982
Phone (813) 681-1122

749 State Rd 60
Lake Wales, FL 33853-4240
Phone (863) 676-7624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.32 of 100Reported as group
Quality
96.85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME42087FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory L Henderson MD Facs Inc Ophthalmology CurrentSince Dec 1, 2021 Accepting new patients
Gregory L Henderson MD Facs Inc Ophthalmology CurrentSince Dec 1, 2021 Accepting new patients
Gregory L Henderson MD Facs Inc Ophthalmology Past Accepting new patients

Locations

403 Vonderburg Dr
Brandon, FL 33511
Phone (813) 681-1122

403 Vonderburg Dr
Fl Eye
Brandon, FL 33511
Phone (813) 681-1122

749 State Road 60 E
Lake Wales, FL 33853
Phone (863) 676-7624

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1235328444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534240",
            "telephone_number": "863-676-7624",
            "fax_number": "863-678-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534240",
            "telephone_number": "863-676-7624",
            "fax_number": "863-678-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNSTEIN",
        "first_name": "ROY",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-24",
        "last_updated": "2024-05-23",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME42087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180020219",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbraunstein@floridaeye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "749 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338534240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.