Individual provider Active NPI

Ryan Sacksteder, O.D.

  • Optometrist
  • Largo, FL
National Provider Identifier
1265780555
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4734 Issued in FL
Practice address
148 13TH St SW
Largo, FL 33770-3127
Phone
(727) 581-8706
Fax
(727) 586-3743
NPI assigned
Aug 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4734 FL Primary

Addresses

Primary practice location

148 13TH St SW
Largo, FL 33770-3127

Mailing address

148 13TH St SW
Largo, FL 33770-3127
Phone (727) 581-8706

Other identifiers 1

IdentifierTypeStateIssuer
006480900MedicaidFL

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
I20120928000468 FL Practitioner - Optometry 3678722089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Physicians of Pinellas, PAGroup PAC ID 5092629071, 39 clinicians

Practice addresses (Care Compare)

148 13TH St SW
Largo, FL 33770-3127
Phone (727) 581-8706

6133 Central Ave
Saint Petersburg, FL 33710-8529
Phone (727) 344-3008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4734FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Jul 30, 2019 Accepting new patients
The Eye Physicians of Pinellas, PA CurrentSince Jul 22, 2013 Accepting new patients
The Eye Physicians of Pinellas, PA Optometrist CurrentSince Jul 22, 2013 Accepting new patients
National Vision, Inc. Past Accepting new patients
The Eye Physicians of Pinellas, PA Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4001 1st St E
Bradenton, FL 34208
Phone (941) 745-9800

10934 N Dale Mabry Hwy
Carrollwood, FL 33618
Phone (813) 559-4990

2660 Gulf To Bay Blvd
Clearwater, FL 33759
Phone (727) 683-7207

30323 US Highway 19 N
Clearwater, FL 33761
Phone (727) 373-3030

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

148 13th St SW
Largo, FL 33770
Phone (727) 450-3030

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

77 N Cattlemen Rd
Sarasota, FL 34243
Phone (941) 893-6109

6133 Central Ave
St Petersburg, FL 33710
Phone (727) 344-3008

2109 66th St N
St Petersburg, FL 33710
Phone (727) 342-5226

3520 4th St N
St Petersburg, FL 33704
Phone (727) 369-0043

1531 S Dale Mabry Hwy
Tampa, FL 33629
Phone (605) 760-1018

10224 E Adamo Dr
Tampa, FL 33619
Phone (813) 315-9898

Interoperability endpoints

  • Direct secure messaging: rsacksteder@directaddress.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1265780555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 13TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703127",
            "telephone_number": "727-581-8706",
            "fax_number": "727-586-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 13TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703127",
            "telephone_number": "727-581-8706",
            "fax_number": "727-586-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKSTEDER",
        "first_name": "RYAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-17",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006480900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.