Organization Active NPI

Roxanne Achong OD, PA

Doing business as Coan Eye Care

  • Optometrist
  • Ocoee, FL
National Provider Identifier
1386665230
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3204 Issued in FL
Legal business name
ROXANNE ACHONG OD, PA
Doing business as
Coan Eye Care
Practice address
10101 W Colonial Dr
Suite 100
Ocoee, FL 34761-4213
Phone
(407) 445-5170
Fax
(407) 299-5036
NPI assigned
Jul 23, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Dr. Roxanne Achong, OD
Title
President
Phone
(407) 445-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3204 FL Primary

Addresses

Primary practice location

10101 W Colonial Dr
Suite 100
Ocoee, FL 34761-4213

Mailing address

10101 W Colonial Dr
Suite 100
Ocoee, FL 34761-4213
Phone (407) 445-5170

Other identifiers 1

IdentifierTypeStateIssuer
6210674300MedicaidFL

Other names 1

  • COAN EYE CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070712000062 FL Part B Supplier - Clinic/Group Practice 2668572280 Receives reassigned benefits from 2 practitioners
Practice locations: Ocoee, FL

National Provider Directory

National Provider Directory

Locations

10101 W Colonial Dr
Ocoee, FL 34761
Phone (407) 445-5170

10101 W Colonial Dr
Ste 100
Ocoee, FL 34761
Phone (407) 445-5170

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1386665230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 W COLONIAL DR",
            "address_2": "SUITE 100",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614213",
            "telephone_number": "407-445-5170",
            "fax_number": "407-299-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W COLONIAL DR",
            "address_2": "SUITE 100",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614213",
            "telephone_number": "407-445-5170",
            "fax_number": "407-299-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROXANNE ACHONG OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "ACHONG",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-445-5170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6210674300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COAN EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.