Individual provider Active NPI

Austin John Mason, OD

  • Optometrist
  • St Petersburg, FL
National Provider Identifier
1417628470
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6016 Issued in FL
Practice address
5712 5TH Ave N
St Petersburg, FL 33710-7104
Phone
(727) 344-0800
NPI assigned
Sep 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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 OPC6016 FL Primary

Addresses

Primary practice location

5712 5TH Ave N
St Petersburg, FL 33710-7104

Mailing address

5712 5TH Ave N
St Petersburg, FL 33710-7104
Phone (727) 344-0800

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
I20211001002588 FL Practitioner - Optometry 4284032434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
John H. Mason P.a. Optometrist CurrentSince Sep 28, 2021 Accepting new patients
John H. Mason P a Optometrist PastSince Sep 28, 2021 Accepting new patients

Locations

5712 5th Ave N
St Petersburg, FL 33710
Phone (727) 344-0800

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1417628470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337107104",
            "telephone_number": "727-344-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5712 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337107104",
            "telephone_number": "727-344-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "AUSTIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.