Clarence Henry Russell III, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OPC2807 Issued in FL

Practice address

3466 Lithia Pinecrest Rd
Valrico, FL 33594-6301

Phone

(813) 657-3937

Fax

(813) 661-9009

NPI assigned

Oct 20, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tampa Eye Clinic and Associates PAGroup PAC ID 8123928868, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clarence.russell.p1@direct.tec.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tampa Eye Clinic and Associates PA

  dba Tampa Eye Clinic

  • Ophthalmology Physician
  • Tampa, FL
  • NPI 1013937861
  Medicare reassignment Care Compare group NPD
• Dr. Chris Russell, PA

  dba Studio Eyes

  • Optometrist
  • Valrico, FL
  • NPI 1073816906
  NPD (past) Authorized official
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487643441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3466 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335946301",
            "telephone_number": "813-657-3937",
            "fax_number": "813-661-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3466 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335946301",
            "telephone_number": "813-657-3937",
            "fax_number": "813-661-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CLARENCE",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC2807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Garden Healthcare Group LLC
• David L Rosenau, PHARMD
• Barbara Jeanne Ross
• Gabriela Ruiz Perez
• Sonia Margarita Ruiz, MD
• Sage Dental of Valrico PLLC
• Fadi Salem, RPH
• Alexis Nicole Samuels
• Mia Zuzanne Sandala
• Sapling Medical Group, P.a.

• Corneal and Contact Management Optometrist in Valrico, FL
• Providers in Valrico, FL by specialty
• Corneal and Contact Management Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.