James Michael Petro, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3266 Issued in FL

Practice address

2140 East Bloomingdale Ave
Walmart Vision Center
Valrico, FL 33596

Phone

(813) 413-3323

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1295953073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 FAIRCOURT DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335967802",
            "telephone_number": "813-262-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 EAST BLOOMINGDALE AVE",
            "address_2": "WALMART VISION CENTER",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "33596",
            "telephone_number": "813-413-3323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28500 State Road 54",
            "address_2": "Walmart Vision Center",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "33543",
            "country_code": "US",
            "telephone_number": "813-262-2623",
            "fax_number": "813-907-1408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRO",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC3266",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "OPC3266",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "FL",
            "license": "OPC3266",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "FL",
            "license": "OPC3266",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER",
            "identifier": "11221055",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Patricia Perez, OTA
• Performance Driven Case Management, LLC
• Maureen Yvonne Peterkin-Byrd, RN
• Elizabeth Ann Petro, RN
• Jacob Matthew Petro
• Sara Michele Pfeifer
• Kim Oanh Pham, PTA
• Tony Nguyen Pham, O.D.
• Jan Denice Phelps, ARNP
• Cheryl Marie Phillips, APN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.