Organization Active NPI

Harbor Ophthalmology, PLLC

  • Ophthalmology Physician
  • Palm Harbor, FL
National Provider Identifier
1477932499
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
HARBOR OPHTHALMOLOGY, PLLC
Practice address
33920 US Highway 19 N
Suite #275
Palm Harbor, FL 34684-2676
Phone
(727) 784-1121
Fax
(727) 781-4788
NPI assigned
May 22, 2015
Last updated
Sep 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Authorized official

Name
Harry Kolodner, M.D.NPI 1932131018
Title
Manager
Phone
(727) 784-1121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

33920 US Highway 19 N
Suite #275
Palm Harbor, FL 34684-2676

Mailing address

33920 US Highway 19 N
Suite #275
Palm Harbor, FL 34684-2676
Phone (727) 784-1121

Other identifiers 1

IdentifierTypeStateIssuer
ME 33861OtherFLSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150915001218 FL Part B Supplier - Clinic/Group Practice 7214244821 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Harbor, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Harbor Ophthalmology PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

33920 US Highway 19 N
Ste 275
Palm Harbor, FL 34684
Phone (727) 784-1121

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1477932499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33920 US HIGHWAY 19 N",
            "address_2": "SUITE #275",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346842676",
            "telephone_number": "727-784-1121",
            "fax_number": "727-781-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33920 US HIGHWAY 19 N",
            "address_2": "SUITE #275",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346842676",
            "telephone_number": "727-784-1121",
            "fax_number": "727-781-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR OPHTHALMOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "KOLODNER",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-784-1121",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "ME 33861",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.