Brandon Sudduth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

APPLYING Issued in FL

Practice address

11406 San Jose Blvd Ste 1
Jacksonville, FL 32223-7953

Phone

(904) 260-3839

Fax

(904) 260-3604

NPI assigned

Aug 13, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Dr. Ted Brink and Associates PAGroup PAC ID 6800936360, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandon.sudduth@direct.revolutionehr.com

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.

• Dr. Ted Brink and Associates PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1427138650
  Medicare reassignment Care Compare group NPD
• Dr.Ted Brink & Associates

  • Optometrist
  • Jacksonville, FL
  • NPI 1730402686
  NPD

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1316370414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11406 SAN JOSE BLVD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237953",
            "telephone_number": "904-260-3839",
            "fax_number": "904-260-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11406 SAN JOSE BLVD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237953",
            "telephone_number": "904-260-3839",
            "fax_number": "904-260-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "BRANDON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4882",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "APPLYING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Successful Women Acknowledged
• Andrew Suchan, MD
• Sandra Jean Suchomski, M.D.
• Olivia Marie Suddarth, PSYD
• Sudduth Vision PLLC
• Rachel Sudhindaran
• Jaime Sued, MD
• Desiree Suero
• Douglas Suffield, DAOM
• Sugar Doctors LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.
• 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.