Individual provider Active NPI

Gerald H Fisher, OD

  • Optometrist
  • Saint Johns, FL
National Provider Identifier
1518049840
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2780 Issued in FL
Practice address
2766 Racetrack Rd
St. Johns, FL 32259-4231
Phone
(904) 287-4567
Fax
(904) 287-4597
NPI assigned
Oct 19, 2006
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2780 FL Primary

Addresses

Primary practice location

2766 Racetrack Rd
St. Johns, FL 32259-4231

Mailing address

2766 Racetrack Rd
St. Johns, FL 32259-4231
Phone (904) 287-4567

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
I20040729000614 FL Practitioner - Optometry 0547230591

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gerald H Fisher and Erika L Fisher, PAGroup PAC ID 0345210399, 4 clinicians

Practice addresses (Care Compare)

2766 Race Track Rd
Saint Johns, FL 32259-4231
Phone (904) 287-4567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2780FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1518049840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2766 RACETRACK RD",
            "city": "ST. JOHNS",
            "state": "FL",
            "postal_code": "322594231",
            "telephone_number": "904-287-4567",
            "fax_number": "904-287-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2766 RACETRACK RD",
            "city": "ST. JOHNS",
            "state": "FL",
            "postal_code": "322594231",
            "telephone_number": "904-287-4567",
            "fax_number": "904-287-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "GERALD",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

Verify at the official NPI Registry.