Individual provider Active NPI

Tejas Dilip Patel, O.D.

  • Optometrist
  • Winter Garden, FL
National Provider Identifier
1477004729
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 5289 Issued in FL
Practice address
16556 Olive Hill Dr
Winter Garden, FL 34787-9272
Phone
(352) 406-9915
NPI assigned
Oct 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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 5289 FL Primary

Addresses

Primary practice location

16556 Olive Hill Dr
Winter Garden, FL 34787-9272

Mailing address

16556 Olive Hill Dr
Winter Garden, FL 34787-9272
Phone (352) 406-9915

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
I20161122000939 FL Practitioner - Optometry 4183903719 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 5289FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients
Eye Doctors Optical Outlets, PA Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Hamlin Eye Care, LLC Optometrist CurrentSince Oct 1, 2020 Accepting new patients

Locations

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

15820 Shaddock Dr
Ste 150
Winter Garden, FL 34787
Phone (407) 798-8485

Interoperability endpoints

  • Direct secure messaging: tejas.patel@uprisedirect.com

Organizations & group practices 4

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": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1477004729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16556 OLIVE HILL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347879272",
            "telephone_number": "352-406-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16556 OLIVE HILL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347879272",
            "telephone_number": "352-406-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TEJAS",
        "middle_name": "DILIP",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-21",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.