Individual provider Active NPI

Bradley Austin, O.D.

  • Optometrist
  • Brandon, FL
National Provider Identifier
1235544750
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4928 Issued in FL
Practice address
2416 W Brandon Blvd
Brandon, FL 33511-4717
Phone
(813) 684-7070
NPI assigned
Jun 23, 2014
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 4928 FL Primary

Addresses

Primary practice location

2416 W Brandon Blvd
Brandon, FL 33511-4717

Mailing address

3056 Satilla Loop
Odessa, FL 33556-2739
Phone (954) 696-3288

Other practice location 1

307 Brandon Town Center Mall
Brandon, FL 33511-4723
Phone (813) 689-7709

Other identifiers 1

IdentifierTypeStateIssuer
014824000MedicaidFL

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
I20150713000211 FL Practitioner - Optometry 5698087146 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4928FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Eyecare Centers PLLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Pearle Capstone Eye Associates, PLLC Optometrist CurrentSince Aug 1, 2025 Accepting new patients

Locations

1929 W Brandon Blvd
Brandon, FL 33511
Phone (813) 684-7071

2416 W Brandon Blvd
Brandon, FL 33511
Phone (813) 684-7070

307 Brandon Town Center Mall
Brandon, FL 33511
Phone (813) 684-0815

25434 Sierra Center Blvd
Lutz, FL 33559
Phone (813) 452-4442

13555 Highway 54
Ste C
Odessa, FL 33556
Phone (813) 454-0670

1601 NW Expressway
Ste 1420
Oklahoma City, OK 73118

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1235544750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 SATILLA LOOP",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562739",
            "telephone_number": "954-696-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 W BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114717",
            "telephone_number": "813-684-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Brandon Town Center Mall",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114723",
            "country_code": "US",
            "telephone_number": "813-689-7709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014824000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.