Active NPI
Michael A. Slusky, OD
- Optometrist
- North Port, FL
National Provider Identifier
1316075070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-008926
- Practice address
- 11700 Mezzo Drive
Optometrist'S Office
North Port, FL 34923 - Phone
- (941) 548-4785
- Fax
- (941) 548-4786
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC5779 | FL | |
| Optometrist | 152W00000X | 046-008926 | IL | Primary |
Addresses
Primary practice location
11700 Mezzo Drive
Optometrist'S Office
North Port, FL 34923
Mailing address
11700 Mezzo Drive
Optometrist'S Office
North Port, FL 34923
Phone (941) 548-4758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC5779 | FL | MD | Optometrist |
| 046-008926 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Shores Vision, Inc | Optometrist | Current | Accepting new patients |
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.
-
- Optometrist
- Hallandale Beach, FL
- NPI 1255953865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1316075070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11700 MEZZO DRIVE",
"address_2": "OPTOMETRIST'S OFFICE",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "34923",
"telephone_number": "941-548-4758",
"fax_number": "941-548-4786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11700 MEZZO DRIVE",
"address_2": "OPTOMETRIST'S OFFICE",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "34923",
"telephone_number": "941-548-4785",
"fax_number": "941-548-4786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLUSKY",
"first_name": "MICHAEL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2024-05-23",
"certification_date": "2024-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC5779",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-008926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Port, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.