NPIMap

Organization Active NPI

Pasadena Eye Center, LLC

  • Ophthalmology Physician
  • St Petersburg, FL
National Provider Identifier
1528083755
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PASADENA EYE CENTER, LLC
Practice address
6950 Central Ave
St Petersburg, FL 33707-1210
Phone
(727) 343-3004
Fax
(727) 343-9521
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Dr. David E. Hall, M.D.NPI 1043202583
Title
Medical Director
Phone
(727) 343-3004

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

6950 Central Ave
St Petersburg, FL 33707-1210

Mailing address

6950 Central Ave
St Petersburg, FL 33707-1210
Phone (727) 343-3004

Other identifiers 3

IdentifierTypeStateIssuer
5451200001OtherFLCIGNA GOVERNMENT SERVICES
DD6403OtherFLRAILROAD MEDICARE
33343OtherFLBLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050906000851 FL Part B Supplier - Clinic/Group Practice 1456383967 Receives reassigned benefits from 10 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

6950 Central Ave
Ste 120
St Petersburg, FL 33707
Phone (727) 343-3004

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1528083755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071210",
            "telephone_number": "727-343-3004",
            "fax_number": "727-343-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071210",
            "telephone_number": "727-343-3004",
            "fax_number": "727-343-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASADENA EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "727-343-3004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "5451200001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD6403",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "33343",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.