Individual provider Active NPI

Thomas Alan Underhill, O.D.

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1477079598
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5456 Issued in FL
Practice address
5995 S Pointe Blvd Ste 111
Fort Myers, FL 33919-3273
Phone
(239) 482-0355
Fax
(239) 482-8930
NPI assigned
Aug 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 OPC5456 FL Primary

Addresses

Primary practice location

5995 S Pointe Blvd Ste 111
Fort Myers, FL 33919-3273

Mailing address

5995 S Pointe Blvd Ste 111
Fort Myers, FL 33919-3273
Phone (239) 482-0355

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
I20171004000476 FL Practitioner - Optometry 5597030353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1565 Matthew Dr
Suite 2
Fort Myers, FL 33907-1734
Phone (239) 482-0355

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vidya P Kini MD PL CurrentSince Aug 21, 2017 Accepting new patients
Doctors Eyecare Center of SW Florida, LLC Optometrist CurrentSince Aug 21, 2017 Accepting new patients

Locations

1565 Matthew Dr
Ste 2
Fort Myers, FL 33907
Phone (239) 274-5464

5995 S Pointe Blvd
Ste 111
Fort Myers, FL 33919
Phone (239) 482-0355

Interoperability endpoints

  • Direct secure messaging: thomas.underhill@direct.revolutionehr.com

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": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477079598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 S POINTE BLVD STE 111",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193273",
            "telephone_number": "239-482-0355",
            "fax_number": "239-482-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 S POINTE BLVD STE 111",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193273",
            "telephone_number": "239-482-0355",
            "fax_number": "239-482-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERHILL",
        "first_name": "THOMAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.