Individual provider Active NPI

Richard Von Weisenberger, O.D.

  • Optometrist
  • Tampa, FL
National Provider Identifier
1558711895
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5275 Issued in FL
Practice address
719 W Fletcher Ave
Tampa, FL 33612-3422
Phone
(813) 961-2020
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002507 VA
Optometrist 152W00000X OPC5275 FL Primary

Addresses

Primary practice location

719 W Fletcher Ave
Tampa, FL 33612-3422

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Phone (813) 972-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rweisenberger149392@direct.tgh.org

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
I20170706000918 FL Practitioner - Optometry 5395014435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bruce W Anderson, P.a.Group PAC ID 0547308819, 4 clinicians

Practice addresses (Care Compare)

13330 Usf Laurel Dr
Tampa, FL 33612-6601

4202 E Fowler Ave
Tampa, FL 33620-6750

719 W Fletcher Ave
Tampa, FL 33612-3422
Phone (813) 961-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5275FLMDOptometrist
0618002507VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 31, 2018 Accepting new patients
Bruce W Anderson, P.a. Optometrist CurrentSince May 5, 2017 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 31, 2018 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

719 W Fletcher Ave
Tampa, FL 33612
Phone (813) 961-2020

13330 Usf Laurel Dr
Fl 4
Tampa, FL 33612
Phone (813) 821-8022

3822 Turman Loop
Wesley Chapel, FL 33544
Phone (813) 961-2020

Interoperability endpoints

  • Direct secure messaging: rweisenberger149392@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1558711895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123422",
            "telephone_number": "813-961-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13000 Bruce B Downs Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124745",
            "country_code": "US",
            "telephone_number": "813-972-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISENBERGER",
        "first_name": "RICHARD",
        "middle_name": "VON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002507",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rweisenberger149392@direct.tgh.org",
            "affiliation": "N",
            "address_1": "719 W Fletcher Ave",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336123422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.