Organization Active NPI

Todd B Lang OD PA

Doing business as Bayside Eye Centre

  • Optometrist
  • Port Charlotte, FL
National Provider Identifier
1346332830
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 2288 Issued in FL
Legal business name
TODD B LANG OD PA
Doing business as
Bayside Eye Centre
Practice address
970 Kings Hwy
Port Charlotte, FL 33980-4216
Phone
(941) 637-0202
Fax
(941) 637-0425
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Dr. Todd B Lang, OD
Title
President
Phone
(941) 637-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 2288 FL Primary

Addresses

Primary practice location

970 Kings Hwy
Port Charlotte, FL 33980-4216

Mailing address

1521 Kensington St
Port Charlotte, FL 33952-2555
Phone (941) 637-0202

Other practice location 1

2560 Business Park Dr NE
Cleveland, TN 37311-3891
Phone (423) 472-5401

Other identifiers 6

IdentifierTypeStateIssuer
2307923OtherFLAETNA
078880500MedicaidFL
19062OtherFLBLUE CROSS BLUE SHIELD
87726OtherFLUNITEDHEALTHCARE
0341776OtherFLCIGNA
410031991OtherFLMEDICARE RAILROAD

Other names 1

  • Bayside Eye Centre Doing business as

National Provider Directory

National Provider Directory

Locations

314 Tamiami Trl
Punta Gorda, FL 33950
Phone (941) 637-0202

314 Tamiami Trl
Unit 112
Punta Gorda, FL 33950
Phone (941) 637-0202

970 Kings Hwy
Punta Gorda, FL 33980
Phone (941) 340-0981

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1346332830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 KENSINGTON ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339522555",
            "telephone_number": "941-637-0202",
            "fax_number": "941-637-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 KINGS HWY",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339804216",
            "telephone_number": "941-637-0202",
            "fax_number": "941-637-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2560 Business Park Dr NE",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373113891",
            "country_code": "US",
            "telephone_number": "423-472-5401",
            "fax_number": "423-479-3060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TODD B LANG OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-637-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2307923",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078880500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "19062",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "87726",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0341776",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410031991",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Eye Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.

Verify at the official NPI Registry.