Edison Eye Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EDISON EYE CARE, PLLC

Practice address

19527 Highland Oaks Dr Ste 203
Estero, FL 33928-9637

Phone

(616) 834-2598

NPI assigned

Sep 28, 2022

Last updated

Sep 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Konynenbelt, ODNPI 1114300472

Title

Member

Phone

(616) 834-2598

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin John Konynenbelt, O.D.

  • Optometrist
  • Estero, FL
  • NPI 1114300472
  Medicare reassignment Care Compare group NPD Authorized official
• Jessie Elizabeth Konynenbelt, O.D.

  • Optometrist
  • Estero, FL
  • NPI 1659749323
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1255055646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 SWEETWATER LN UNIT 2305",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341104177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19527 HIGHLAND OAKS DR STE 203",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339289637",
            "telephone_number": "616-834-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "KONYNENBELT",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "616-834-2598",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Estero, FL
• Providers in Estero, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.