NPIMap

Organization Active NPI

Suncoast Eye Center PA

  • Ophthalmology Physician
  • Hudson, FL
National Provider Identifier
1487643631
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SUNCOAST EYE CENTER PA
Practice address
14003 Lakeshore Blvd
Hudson, FL 34667-7124
Phone
(727) 868-9442
Fax
(727) 862-6210
NPI assigned
Oct 20, 2005
Last updated
Sep 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Authorized official

Name
Dr. Alan M Freedman, M.D.NPI 1154311140
Title
President/Medical Director
Phone
(727) 868-9442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

14003 Lakeshore Blvd
Hudson, FL 34667-7124

Mailing address

14003 Lakeshore Blvd
Hudson, FL 34667-7124
Phone (727) 868-9442

Other identifiers 3

IdentifierTypeStateIssuer
CL6228OtherFLRR MEDICARE
98920OtherFLBCBSFL
253038400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070831000439 FL Part B Supplier - Clinic/Group Practice 4789777087 Receives reassigned benefits from 9 practitioners
Practice locations: Crystal River, FL; Hudson, 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
Suncoast Eye Center PA2 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

221 NE US Highway 19
Crystal River, FL 34429
Phone (352) 795-2526

Interoperability endpoints

  • Direct secure messaging: afreedman@suncoast.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 10

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": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1487643631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14003 LAKESHORE BLVD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677124",
            "telephone_number": "727-868-9442",
            "fax_number": "727-862-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14003 LAKESHORE BLVD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677124",
            "telephone_number": "727-868-9442",
            "fax_number": "727-862-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "FREEDMAN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "727-868-9442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CL6228",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "98920",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253038400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.