Stacey Lee McDonald, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3363 Issued in FL

Practice address

36 Eglin Pkwy NE
Fort Walton Beach, FL 32548-4915

Phone

(850) 243-3111

NPI assigned

Mar 27, 2006

Last updated

Mar 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Stacey Lee Lusk Former name

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fort Walton Beach Vision Center LLC

  dba The VIsion Hub at Fort Walton Beach

  • Optometrist
  • Fort Walton Beach, FL
  • NPI 1225706112
  Medicare reassignment NPD
• The Vision Hub LLC

  dba The Vision Hub at Defuniak Springs

  • Optometrist
  • Defuniak Springs, FL
  • NPI 1720652316
  Medicare reassignment NPD
• F & M of Milton Inc

  dba Joslin Family Eyecare

  • Optometrist
  • Milton, FL
  • NPI 1982790341
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1518927052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PALAFOX PL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025629",
            "telephone_number": "850-434-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 EGLIN PKWY NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484915",
            "telephone_number": "850-243-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "STACEY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112657200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "LUSK",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marianne L McCain, PH.D.
• Marielle McClellan-Jung
• Mathew McCune, M.D.
• Emily C. McDevitt, D.O.
• Marina B McDonald, PT
• Cassie McDonnell, APRN
• Jenna McElyea, LPN
• Larry C McFarland, LMHC
• Karen Anne McGavin, LCSW
• Christin L McGee, LMT

• Optometrist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.