NPIMap

Organization Active NPI

Filutowski Eye Institute PA

  • Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1306910385
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FILUTOWSKI EYE INSTITUTE PA
Practice address
110 Yorktowne Drive
Daytona Beach, FL 32119
Phone
(386) 788-6696
Fax
(386) 788-2219
NPI assigned
Nov 20, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Konrad W Filutowski, MDNPI 1134295744
Title
President and Medical Director
Phone
(407) 333-5111

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X FL Primary

Addresses

Primary practice location

110 Yorktowne Drive
Daytona Beach, FL 32119

Mailing address

110 Yorktowne Dr
Daytona Beach, FL 32119-1471
Phone (386) 788-6696

Other identifiers 3

IdentifierTypeStateIssuer
058564500MedicaidFL
0082522OtherFLGHI
21305OtherFLBCBSFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080910000126 FL Part B Supplier - Clinic/Group Practice 6406843945 Receives reassigned benefits from 28 practitioners
2 other NPIs on this enrollment
Practice locations: Daytona Beach, FL; Lake Mary, FL; Orlando, FL

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Filutowski Eye Institute PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1306910385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 YORKTOWNE DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321191471",
            "telephone_number": "386-788-6696",
            "fax_number": "386-788-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 YORKTOWNE DRIVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32119",
            "telephone_number": "386-788-6696",
            "fax_number": "386-788-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FILUTOWSKI EYE INSTITUTE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "FILUTOWSKI",
        "authorized_official_first_name": "KONRAD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-333-5111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058564500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0082522",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "21305",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.