Individual provider Active NPI

Paul Alexander Southby, O.D.

  • Optometrist
  • Port Richey, FL
National Provider Identifier
1376502765
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2802 Issued in FL
Practice address
9644 Scenic Dr
Port Richey, FL 34668-4653
Phone
(727) 845-0082
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2802 FL Primary

Addresses

Primary practice location

9644 Scenic Dr
Port Richey, FL 34668-4653

Mailing address

9644 Scenic Dr
Port Richey, FL 34668-4653
Phone (727) 845-0082

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
I20050202000300 FL Practitioner - Optometry 5395796817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John L. Meyers, OD PAGroup PAC ID 2668495532, 5 clinicians

Practice addresses (Care Compare)

9409 US Hwy 19
Suite 336
Port Richey, FL 34668-4632
Phone (727) 845-5506

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2802FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Associates of Florida, P.a. Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1376502765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9644 SCENIC DR",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346684653",
            "telephone_number": "727-845-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9644 SCENIC DR",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346684653",
            "telephone_number": "727-845-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHBY",
        "first_name": "PAUL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Richey, FL

Sources for this page

Verify at the official NPI Registry.