Individual provider Active NPI

John Kudryk, O.D.

  • Optometrist
  • Clearwater, FL
National Provider Identifier
1376500975
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1664 Issued in FL
Practice address
14775 Feather Cove Rd
Clearwater, FL 33762-3018
Phone
(813) 731-3276
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1664 FL Primary

Addresses

Primary practice location

14775 Feather Cove Rd
Clearwater, FL 33762-3018

Mailing address

14775 Feather Cove Rd
Clearwater, FL 33762-3018
Phone (813) 731-3276

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
I20060508000480 FL Practitioner - Optometry 5698786564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Craig Berger MD PLGroup PAC ID 0547368995, 5 clinicians

Practice addresses (Care Compare)

3242 Cove Bend Dr
Tampa, FL 33613-2752
Phone (813) 265-6940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1664FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Larry M. Perich Dopa Optometrist CurrentSince Feb 6, 2013 Accepting new patients
Craig Berger MD PL CurrentSince Jul 20, 2023 Accepting new patients
Lebowitz Medical Group PA PastSince Jul 20, 2023 Accepting new patients
Florida Vision Institute Inc Optometrist PastSince Feb 9, 2013 Accepting new patients
Brandon Eye Associates PA Optometrist Past Accepting new patients

Locations

2020 Seven Springs Blvd
New Pt Richey, FL 34655
Phone (727) 372-1311

3242 Cove Bend Dr
Tampa, FL 33613
Phone (813) 265-6940

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376500975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14775 FEATHER COVE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623018",
            "telephone_number": "813-731-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14775 FEATHER COVE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623018",
            "telephone_number": "813-731-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDRYK",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "1664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.