Individual provider Active NPI

Jannah Miller Landsaw, O.D.

  • Optometrist
  • Tavernier, FL
National Provider Identifier
1568512911
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3357 Issued in FL
Practice address
91284 Overseas Hwy
Tavernier, FL 33070-2555
Phone
(305) 853-3153
Fax
(305) 853-3152
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3357 FL Primary

Addresses

Primary practice location

91284 Overseas Hwy
Tavernier, FL 33070-2555

Mailing address

91284 Overseas Hwy
Tavernier, FL 33070-2555
Phone (305) 853-3153

Other identifiers 2

IdentifierTypeStateIssuer
4449800001OtherFLMEDICARE NSC
620717100MedicaidFL

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
I20101227000194 FL Practitioner - Optometry 0042408643 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3357FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Landsaw O D P a Optometrist CurrentSince Oct 21, 2010 Accepting new patients

Locations

91200 Overseas Hwy
Ste 15
Tavernier, FL 33070
Phone (305) 853-3152

91284 Overseas Hwy
Tavernier, FL 33070
Phone (305) 853-3153

Organizations & group practices 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1568512911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91284 OVERSEAS HWY",
            "city": "TAVERNIER",
            "state": "FL",
            "postal_code": "330702555",
            "telephone_number": "305-853-3153",
            "fax_number": "305-853-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91284 OVERSEAS HWY",
            "city": "TAVERNIER",
            "state": "FL",
            "postal_code": "330702555",
            "telephone_number": "305-853-3153",
            "fax_number": "305-853-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSAW",
        "first_name": "JANNAH",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "4449800001",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620717100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavernier, FL

Sources for this page

Verify at the official NPI Registry.