Keith C Charles, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0069013 Issued in FL

Practice address

17560 Highway 441
Mount Dora, FL 32757-6711

Phone

(352) 735-2020

Fax

(352) 735-3233

NPI assigned

May 23, 2005

Last updated

Nov 11, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Ophthalmology

Education

University of Southern California Keck School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid Florida Eye Center PAGroup PAC ID 4385678747, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: drcharles@midfloridaeye.ecldirect.net
• Direct secure messaging: kcharles@espflorida.intellechartdirect.net
• Direct secure messaging: keith.charles.p4@direct.drea.nextgenshare.com

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.

• Mid Florida Eye Center PA

  • Ophthalmology Physician
  • Mount Dora, FL
  • NPI 1710980883
  Medicare reassignment Care Compare group NPD
• Delray Eye Associates PA

  • Ophthalmology Physician
  • Delray Beach, FL
  • NPI 1851957112
  NPD
• Mid Florida Eye Center, PA

  • Ophthalmology Physician
  • The Villages, FL
  • NPI 1922434851
  NPD
• First Image Optical LC

  • Durable Medical Equipment & Medical Supplies
  • Wildwood, FL
  • NPI 1194256545
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1255334389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17560 HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576711",
            "telephone_number": "352-735-2020",
            "fax_number": "352-735-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17560 HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576711",
            "telephone_number": "352-735-2020",
            "fax_number": "352-735-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "KEITH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0069013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378726500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180031377",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chain of Lakes Counseling, PLLC
• Aviles J Champion
• Destiny Elaine Chance, RBT
• Khai Sheng Chang, MD
• Celeste Poulin Chaput
• Gina Charleston
• Havilah Ruwarashe Chifupi
• Chinyere Center for Wellness, LLC
• Chirolab 360 Sport & Spine PLLC
• Angela C Chiu, PHARMD, RPH

• Ophthalmology Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.