Individual provider Active NPI

Peter Graves Livingston, M.D.

  • Ophthalmology Physician
  • Bradenton, FL
National Provider Identifier
1598718553
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME102736 Issued in FL
Practice address
5117 26TH St W
Suite B
Bradenton, FL 34207-2203
Phone
(941) 567-4078
Fax
(941) 896-7878
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 13218R LA
Ophthalmology Physician 207W00000X ME102736 FL Primary

Addresses

Primary practice location

5117 26TH St W
Suite B
Bradenton, FL 34207-2203

Mailing address

5117 26TH St W
Suite B
Bradenton, FL 34207-2203
Phone (941) 567-4078

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081003000232 FL Practitioner - Ophthalmology 8022017698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Massachusetts Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5117 26TH St W
Suite B
Bradenton, FL 34207-2203
Phone (941) 567-4078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME102736FLMDOphthalmology Physician
13218RLAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manatee Sarasota Eye Clinic PA Ophthalmology CurrentSince Feb 22, 2012 Accepting new patients
Joseph E Humble and Raymond Haik, PTRS Ophthalmology Current Accepting new patients

Locations

217 Manatee Ave E
Bradenton, FL 34208
Phone (941) 748-1818

6310 Health Park Way
Ste 340
Lakewood Ranch, FL 34202
Phone (914) 748-1818

1804 N 7th St
West Monroe, LA 71291
Phone (318) 325-2610

Organizations & group practices 3

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1598718553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5117 26TH ST W",
            "address_2": "SUITE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342072203",
            "telephone_number": "941-567-4078",
            "fax_number": "941-896-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5117 26TH ST W",
            "address_2": "SUITE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342072203",
            "telephone_number": "941-567-4078",
            "fax_number": "941-896-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "PETER",
        "middle_name": "GRAVES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "13218R",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME102736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.