East Lake Eyecare & Eyewear Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

3810 Issued in FL

Legal business name

EAST LAKE EYECARE & EYEWEAR INC

Practice address

3434 E Lake Rd Ste 3
Palm Harbor, FL 34685-2401

Phone

(727) 781-7922

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tara M Rusoff, O.D.NPI 1235144023

Title

President

Phone

(727) 781-7922

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

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

• Tara M Rusoff, O.D.

  • Optometrist
  • Palm Harbor, FL
  • NPI 1235144023
  Medicare reassignment Care Compare group NPD Authorized official
• Stacey Allan Wenger, O.D.

  • Optometrist
  • Tampa, FL
  • NPI 1427014075
  Medicare reassignment Care Compare group NPD
• Gregory A Lieb, OD

  • Optometrist
  • Tampa, FL
  • NPI 1962400952
  NPD (past)
• Kristin L Bender, O.D

  • Optometrist
  • Johns Creek, GA
  • NPI 1205861846
  NPD (past)
• Angela M. Bernardo, O.D.

  • Optometrist
  • Los Angeles, CA
  • NPI 1326038217
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411171200000",
    "number": "1578633442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 E LAKE RD STE 3",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852401",
            "telephone_number": "727-781-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 E LAKE RD STE 3",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852401",
            "telephone_number": "727-781-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LAKE EYECARE & EYEWEAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-09-20",
        "status": "A",
        "authorized_official_last_name": "RUSOFF",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-781-7922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DVG Ventures, LLC (ComForCare Home Care Pinellas County-North)
• James A Dwyer, M.D
• Dynamic Total Health, L.L.C
• Bruce Dyson
• E-RX Labs LLC
• East Lake Oncology
• East West Healing Solutions
• Eastlake Medical Center PA
• Jennifer Kristin Eaton, LCSW
• Christine M Echeverri

• Optometrist in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2014; 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.