Individual provider Active NPI

Nisha Patel

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1356820211
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5554 Issued in FL
Practice address
14964 Max Leggett Pkwy Ste 106
Jacksonville, FL 32218-7270
Phone
(904) 913-1071
NPI assigned
Aug 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC5554 FL Primary

Addresses

Primary practice location

14964 Max Leggett Pkwy Ste 106
Jacksonville, FL 32218-7270

Mailing address

110 College St Ste E
Athens, AL 35611-2714

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
I20190220000740 FL Practitioner - Optometry 0143568949 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA Single Specialty CurrentSince Jun 11, 2019 Accepting new patients
Sightrite Medical FL PLLC Optometrist CurrentSince Jun 1, 2023 Accepting new patients
National Vision, Inc. Past Accepting new patients
Vision Today PLLC Optometrist PastSince Dec 1, 2018 Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

575 Lamar Ave
Brooksville, FL 34601
Phone (352) 799-2226

2254 W International Speedway Blvd
Daytona Beach, FL 32114
Phone (386) 252-3639

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

13534 Beach Blvd
#3
Jacksonville, FL 32224
Phone (904) 383-3400

17781 Thelma Ave
Jupiter, FL 33458
Phone (561) 746-2998

104 W Vine St
Ste C
Kissimmee, FL 34741
Phone (407) 944-4240

1800 NE 168th St
North Miami Beach, FL 33162
Phone (305) 917-1800

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

901 Blanding Blvd
Ste 4
Orange Park, FL 32065
Phone (904) 562-1160

3808 E Colonial Dr
Orlando, FL 32803
Phone (407) 894-7533

267 Broadway
Brooklyn, NY 11211

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

Organizations & group practices 6

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": "1533945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1356820211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLLEGE ST STE E",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14964 MAX LEGGETT PKWY STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187270",
            "telephone_number": "904-913-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-11",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.