NPIMap

Organization Active NPI

Gregory L Henderson MD Facs Inc

Doing business as Florida Eye Specialists and Cataract Institute

  • Ophthalmology Physician
  • Brandon, FL
National Provider Identifier
1306839725
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GREGORY L HENDERSON MD FACS INC
Doing business as
Florida Eye Specialists and Cataract Institute
Practice address
403 Vonderburg Dr
Brandon, FL 33511-5982
Phone
(813) 681-1122
Fax
(813) 684-4924
NPI assigned
Aug 31, 2005
Organization subpart
Yes
Parent organization
GREGORY L HENDERSON MD FACS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Gregory L Henderson Sr., MDNPI 1427055227
Title
President
Phone
(813) 681-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

403 Vonderburg Dr
Brandon, FL 33511-5982

Mailing address

403 Vonderburg Dr
Brandon, FL 33511-5982
Phone (813) 681-1122

Other identifiers 3

IdentifierTypeStateIssuer
0609838-00MedicaidFL
060983800MedicaidFL
5019195OtherFLAETNA

Other names 1

  • Florida Eye Specialists and Cataract Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040722001097 FL Part B Supplier - Clinic/Group Practice 9739172321 Receives reassigned benefits from 52 practitioners
4 other NPIs on this enrollment
Practice locations: Riverview, FL; Tampa, FL; Sun City Center, FL; Ruskin, FL; Plant City, FL; Lake Wales, FL; Brandon, FL
O20100930032008 FL DME Supplier - Physician - OptometristDME Supplier - Optician 9739172321 Practice locations: Brandon, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2058105Florida Eye Specialists and Cataract Institute403 Vonderburg Dr, Brandon, FL 33511Certificate of waiverApr 29, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Gregory L Henderson MD Facs Inc403 Vonderburg Dr, Brandon, FL 33511-5501(813) 681-1122 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Part of
Gregory L Henderson MD Facs Inc

Locations

403 Vonderburg Dr
Fl Eye
Brandon, FL 33511
Phone (813) 681-1122

403 Vonderburg Dr
Ste 101
Brandon, FL 33511
Phone (813) 681-1122

2002 S Alexander St
Plant City, FL 33563
Phone (813) 754-3593

13106 Vail Ridge Dr
Fl Eye
Riverview, FL 33579
Phone (813) 392-3311

1701 Rickenbacker Dr
Ste 102
Sun City Center, FL 33573
Phone (813) 634-8877

Interoperability endpoints

  • Direct secure messaging: dsabin@floridaeye.intellechartdirect.net
  • Direct secure messaging: jdeapodaca@floridaeye.intellechartdirect.net
  • Direct secure messaging: jmines@floridaeye.intellechartdirect.net
  • Direct secure messaging: glieb@floridaeye.intellechartdirect.net
  • Direct secure messaging: cnissinoff@floridaeye.intellechartdirect.net
  • Direct secure messaging: apatel@floridaeye.intellechartdirect.net
  • Direct secure messaging: mhedayat@floridaeye.intellechartdirect.net
  • Direct secure messaging: cdonovan@floridaeye.intellechartdirect.net
  • Direct secure messaging: egreenberg@floridaeye.intellechartdirect.net
  • Direct secure messaging: cnaguib@floridaeye.intellechartdirect.net
  • Direct secure messaging: rowsiak@floridaeye.intellechartdirect.net
  • Direct secure messaging: mgitchel@floridaeye.intellechartdirect.net
  • Direct secure messaging: dtsilionis@floridaeye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306839725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115982",
            "telephone_number": "813-681-1122",
            "fax_number": "813-684-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115982",
            "telephone_number": "813-681-1122",
            "fax_number": "813-684-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY L HENDERSON MD FACS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREGORY L HENDERSON MD FACS INC",
        "enumeration_date": "2005-08-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-681-1122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0609838-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060983800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5019195",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Eye Specialists and Cataract Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.