Individual provider Active NPI

Kendall Beissinger, O.D

  • Optometrist
  • Winter Haven, FL
National Provider Identifier
1457731416
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5050 Issued in FL
Practice address
410 E Central Ave
Winter Haven, FL 33880-3050
Phone
(863) 412-8461
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5050 FL Primary

Addresses

Primary practice location

410 E Central Ave
Winter Haven, FL 33880-3050

Mailing address

410 E Central Ave
Winter Haven, FL 33880-3050
Phone (863) 412-8461

Other practice location 1

7024 Siegen Ln
Baton Rouge, LA 70809-4531
Phone (863) 412-8461

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
I20220906001788 FL Practitioner - Optometry 1456735737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eyecare of Winter Haven PLLCGroup PAC ID 1658636956, 3 clinicians

Practice addresses (Care Compare)

410 E Central Ave
Winter Haven, FL 33880-3050
Phone (863) 293-0276

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare of Winter Haven PLLC Optometrist CurrentSince Aug 23, 2022 Accepting new patients
Kevin L. Henne O.D. Optometrist PastSince Aug 23, 2022 Accepting new patients

Locations

410 E Central Ave
Winter Haven, FL 33880
Phone (863) 293-0276

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1457731416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803050",
            "telephone_number": "863-412-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803050",
            "telephone_number": "863-412-8461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7024 Siegen Ln",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708094531",
            "country_code": "US",
            "telephone_number": "863-412-8461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEISSINGER",
        "first_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.