Individual provider Active NPI

Joe R. Evans III, O.D.

  • Optometrist
  • Defuniak Springs, FL
National Provider Identifier
1407224405
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 5138 Issued in FL
Practice address
770 US Highway 331 S
Suite 1
Defuniak Springs, FL 32435-3300
Phone
(850) 892-5514
Fax
(850) 892-0189
NPI assigned
Sep 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 5138 FL Primary

Addresses

Primary practice location

770 US Highway 331 S
Suite 1
Defuniak Springs, FL 32435-3300

Mailing address

770 US Highway 331 S
Suite 1
Defuniak Springs, FL 32435-3300
Phone (850) 892-5514

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
I20160713001715 FL Practitioner - Optometry 8022311315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okaloosa Eye Care PAGroup PAC ID 0840211645, 3 clinicians

Practice addresses (Care Compare)

207 N Main St
Crestview, FL 32536-3543
Phone (850) 683-0221

Merit-based Incentive Payment System (MIPS)

Final score
92.24 of 100Reported as group
Quality
84.48
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 5138FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Okaloosa Eye Care PA Optometrist CurrentSince Feb 1, 2022 Accepting new patients
Eye Care Physicians Inc PastSince Feb 1, 2022 Accepting new patients

Locations

207 N Main St
Crestview, FL 32536
Phone (850) 683-0221

Interoperability endpoints

  • Direct secure messaging: dr.robby@okaloosaeyecare.eyefinity-direct.com

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1407224405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 US HIGHWAY 331 S",
            "address_2": "SUITE 1",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324353300",
            "telephone_number": "850-892-5514",
            "fax_number": "850-892-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 US HIGHWAY 331 S",
            "address_2": "SUITE 1",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324353300",
            "telephone_number": "850-892-5514",
            "fax_number": "850-892-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Defuniak Springs, FL

Sources for this page

Verify at the official NPI Registry.