Jay Justin Older, MD

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

ME21356 Issued in FL

Practice address

4444 E Fletcher Ave Ste D
Tampa, FL 33613-4905

Phone

(813) 971-3846

Fax

(813) 977-2611

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pasadena Eye Center, LLC

  • Ophthalmology Physician
  • St Petersburg, FL
  • NPI 1528083755
  Medicare reassignment NPD
• Paul Herschel Bowman MD

  • MOHS-Micrographic Surgery Physician
  • Tampa, FL
  • NPI 1558378141
  Medicare reassignment NPD
• The Eye Physicians of Pinellas, PA

  • Ophthalmology Physician
  • Largo, FL
  • NPI 1114925153
  Medicare reassignment NPD
• The Eye Physicians of Pinellas, PA

  • Durable Medical Equipment & Medical Supplies
  • Lakeland, FL
  • NPI 1790488013
  NPD
• The Eye Physicians of Pinellas, PA

  • Ambulatory Surgical Clinic/Center
  • Largo, FL
  • NPI 1366710741
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1477531432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 E FLETCHER AVE STE D",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134905",
            "telephone_number": "813-971-3846",
            "fax_number": "813-977-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E FLETCHER AVE STE D",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134905",
            "telephone_number": "813-971-3846",
            "fax_number": "813-977-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDER",
        "first_name": "JAY",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME21356",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME21356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "ME0021356",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1036672011",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL #",
            "identifier": "29789",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "181907220",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "624179",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kehinde Tolulope Olaleye
• Olamiju Olaleye, APRN
• Isabella Sofia Olarte
• Olayinka Bankole MD PA
• Older & Slonim MD'S PA
• Kendra Marie Olderog, PHARMD
• Charlotte A. Oleary, M.D.
• Christina Oleary
• Mandy Flannery Oleary, MD,MPH
• Sally E Olembo

• Ophthalmic Plastic and Reconstructive Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.