Organization Active NPI

Strabismus Surgeons of Tampa LLC

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Tampa, FL
National Provider Identifier
1588557458
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
Legal business name
STRABISMUS SURGEONS OF TAMPA LLC
Practice address
5420 Webb Rd Ste B2
Tampa, FL 33615-3255
Phone
(606) 692-0789
NPI assigned
May 30, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Phaedra L Shudra
Title
Credentialing and Contracting Speci
Phone
(813) 785-4861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0110X Primary

Addresses

Primary practice location

5420 Webb Rd Ste B2
Tampa, FL 33615-3255

Mailing address

5420 Webb Rd Ste B2
Tampa, FL 33615-3255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250611001986 FL Part B Supplier - Clinic/Group Practice 1759891435 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1748563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1588557458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WEBB RD STE B2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 WEBB RD STE B2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153255",
            "telephone_number": "606-692-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRABISMUS SURGEONS OF TAMPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "SHUDRA",
        "authorized_official_first_name": "PHAEDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING AND CONTRACTING SPECI",
        "authorized_official_telephone_number": "813-785-4861"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.