Amanda Nicole Coppedge, O.D.
Individual provider Active NPI Optometrist · Lecanto, FL
NPI 1356533566 · NPPES record last updated Jul 20, 2011
Key facts
- NPI
- 1356533566
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPC4215 (FL)
- Practice address
- 240 N. Lecanto Hwy.
Lecanto, FL 34461 - Phone
- (352) 746-2246
- NPI assigned
- Aug 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Coppedge Eyecare, LLC
Practice addresses (Care Compare)
86 Ponce de Leon Blvd
Brooksville, FL 34601-2818
Phone (352) 796-2141
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 59 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071002000718 | FL | Practitioner - Optometry | 0446345789 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC4215 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coppedge Eyecare, LLC | Optometrist | Current |
Accepting new patients |
| West Coast Eye Institute PA | Optometrist | Current |
Accepting new patients |
| Coppedge and Wooster PA | Optometrist | Past |
Accepting new patients |
Locations
86 Ponce de Leon Blvd
Brooksville, FL 34601
Phone (352) 796-2141
240 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 746-2246
Interoperability endpoints
- amanda.coppedge@direct.revolutionehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC4215 | FL | Yes |
Addresses
Primary practice location
240 N. Lecanto Hwy.
Lecanto, FL 34461
Mailing address
240 N Lecanto Hwy
Lecanto, FL 34461-9191
Phone (352) 746-2246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001339500 | Medicaid | FL |
Other providers in Lecanto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.