Advanced Vision Institute, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME79154 Issued in FL

Legal business name

ADVANCED VISION INSTITUTE, PA

Practice address

220 N Westmonte Dr Ste F
Altamonte Springs, FL 32714-3360

Phone

(407) 389-0800

Fax

(407) 389-1880

NPI assigned

Oct 12, 2007

Organization subpart

No

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

Authorized official

Name

Osama Omar, M.D.NPI 1639104318

Title

Medical Director

Phone

(407) 389-0800

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Osama Hassan Omar, M.D.

  • Ophthalmology Physician
  • Altamonte Springs, FL
  • NPI 1639104318
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1437347622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N WESTMONTE DR STE F",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143360",
            "telephone_number": "407-389-0800",
            "fax_number": "407-389-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N WESTMONTE DR STE F",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143360",
            "telephone_number": "407-389-0800",
            "fax_number": "407-389-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION INSTITUTE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-389-0800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME79154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103863900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58674",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7779377",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.