Active NPI
Eric A Fazio, O.D.
- Optometrist
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC3003
- Practice address
- 13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446 - Phone
- (813) 908-2020
- Fax
- (813) 908-2133
- NPI assigned
- Sep 19, 2005
- Last updated
- Mar 6, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC3003 | FL | Primary |
Addresses
Primary practice location
13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Mailing address
13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Phone (813) 908-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006636600 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Waterloo - School of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Phone (813) 908-2020
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.55 of 100
- Quality
- 99.98
- Improvement activities
- 40
- Cost
- 75.2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newsom Eye & Laser Center, Inc. | Optometrist | Current | Accepting new patients |
| Newsom Eye & Laser Center Inc | Optometrist | Current | Accepting new patients |
| Newsom Eye & Laser Center, Inc. | Optometrist | Past | Accepting new patients |
Locations
14543 Cortez Blvd
Brooksville, FL 34613
Phone (352) 596-4030
3205 Physicians Way
Sebring, FL 33870
Phone (863) 385-1544
4211 US 27 N
Sebring, FL 33870
Phone (863) 385-1544
113 S Armenia Ave
Tampa, FL 33609
Phone (813) 908-2020
13904 N Dale Mabry Hwy
Ste 200
Tampa, FL 33618
Phone (813) 908-2020
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1447245246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13904 N DALE MABRY HWY",
"address_2": "SUITE 200",
"city": "TAMPA",
"state": "FL",
"postal_code": "336182446",
"telephone_number": "813-908-2020",
"fax_number": "813-908-2133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13904 N DALE MABRY HWY",
"address_2": "SUITE 200",
"city": "TAMPA",
"state": "FL",
"postal_code": "336182446",
"telephone_number": "813-908-2020",
"fax_number": "813-908-2133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZIO",
"first_name": "ERIC",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC3003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006636600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.