NPIMap

Organization Active NPI

Family Eye Care Center of Jacksonville PA

  • Ophthalmology Physician
  • Jacksonville, FL
National Provider Identifier
1598729352
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME75604 Issued in FL
Legal business name
FAMILY EYE CARE CENTER OF JACKSONVILLE PA
Practice address
8833 Perimeter Park Blvd
Suite 403
Jacksonville, FL 32216-1110
Phone
(904) 996-7774
Fax
(904) 996-9511
NPI assigned
Apr 17, 2006
Last updated
Mar 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Dr. Adam David Koenigsberg, MDNPI 1063475176
Title
President
Phone
(904) 996-7774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X ME75604 FL Primary

Addresses

Primary practice location

8833 Perimeter Park Blvd
Suite 403
Jacksonville, FL 32216-1110

Mailing address

8833 Perimeter Park Blvd
Suite 403
Jacksonville, FL 32216-1110
Phone (904) 996-7774

Other identifiers 1

IdentifierTypeStateIssuer
259193600MedicaidFL

National Provider Directory

National Provider Directory

Locations

8833 Perimeter Park Blvd
#4
Jacksonville, FL 32216
Phone (904) 996-7774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1598729352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8833 PERIMETER PARK BLVD",
            "address_2": "SUITE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161110",
            "telephone_number": "904-996-7774",
            "fax_number": "904-996-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8833 PERIMETER PARK BLVD",
            "address_2": "SUITE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161110",
            "telephone_number": "904-996-7774",
            "fax_number": "904-996-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE CENTER OF JACKSONVILLE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "KOENIGSBERG",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-996-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME75604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259193600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.