Individual provider Active NPI

Edward Macdonald, OD

  • Optometrist
  • Winter Springs, FL
National Provider Identifier
1295847176
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3489 Issued in FL
Practice address
1122 E Sr 434
Suite 1000
Winter Springs, FL 32708
Phone
(407) 327-5560
Fax
(407) 327-7873
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3489 FL Primary

Addresses

Primary practice location

1122 E Sr 434
Suite 1000
Winter Springs, FL 32708

Mailing address

1122 E Sr 434
Suite 1000
Winter Springs, FL 32708
Phone (407) 327-5560

Other identifiers 1

IdentifierTypeStateIssuer
K7973OtherMEDICARE GROUP ID

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
I20050809000214 FL Practitioner - Optometry 9133158587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 E Sr
434 Suite 1000
Winter Springs, FL 32708-2723
Phone (407) 620-0191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3489FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Macdonald O D P a Optometrist CurrentSince Jan 20, 2004 Accepting new patients

Locations

1122 E State Road 434
Ste 1000
Winter Springs, FL 32708
Phone (407) 327-5560

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1295847176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 E SR 434",
            "address_2": "SUITE 1000",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "32708",
            "telephone_number": "407-327-5560",
            "fax_number": "407-327-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E SR 434",
            "address_2": "SUITE 1000",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "32708",
            "telephone_number": "407-327-5560",
            "fax_number": "407-327-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "K7973",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

Verify at the official NPI Registry.