Individual provider Active NPI

Charles Steven Lancaster, O.D.

  • Optometrist
  • Jacksonville Beach, FL
National Provider Identifier
1316032204
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1541 Issued in FL
Practice address
3316 3Rd St S
Suite 103
Jacksonville Beach, FL 32250-6073
Phone
(904) 241-7865
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1541 FL Primary

Addresses

Primary practice location

3316 3Rd St S
Suite 103
Jacksonville Beach, FL 32250-6073

Mailing address

204 Lora St
Neptune Beach, FL 32266-4941
Phone (904) 249-6215

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
I20100630000643 FL Practitioner - Optometry 5496886780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Eye Institute, P.a.Group PAC ID 2466434386, 10 clinicians

Practice addresses (Care Compare)

3316 3Rd St S
Suite 103
Jacksonville, FL 32250-6090
Phone (904) 241-7865

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1541FLMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Eye Institute, P.a. Optometrist CurrentSince Jan 1, 2001 Accepting new patients
Atlantic Eye Institute P.a. CurrentSince Jan 1, 2001 Accepting new patients
Harris Wilcox and Donovan PA Optometrist Current Accepting new patients
Harris Wilcox and Donovan PA CurrentSince Oct 1, 2021 Accepting new patients
Harris Wilcox and Donovan P a Optometrist CurrentSince Oct 1, 2021 Accepting new patients

Locations

6207 Bennett Rd
Jacksonville, FL 32216
Phone (904) 731-4515

13457 Atlantic Blvd
Ste 5
Jacksonville, FL 32225
Phone (904) 221-9110

3316 3rd St S
Ste 103
Jax Bch, FL 32250
Phone (904) 241-7865

2023 Professional Center Dr
Orange Park, FL 32073
Phone 9042722020234

Organizations & group practices 5

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316032204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 LORA ST",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322664941",
            "telephone_number": "904-249-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 3RD ST S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506073",
            "telephone_number": "904-241-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "CHARLES",
        "middle_name": "STEVEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.