Organization Active NPI

Plastic Eye Surgery Associates P a

  • Legal Medicine
  • Pensacola, FL
National Provider Identifier
1629161633
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
ME49837 Issued in FL
Legal business name
PLASTIC EYE SURGERY ASSOCIATES P A
Practice address
17 E Main St
Ste 100
Pensacola, FL 32502-5998
Phone
(850) 473-0990
Fax
(850) 473-0790
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Dr. James Randall Patrinely, M.D.NPI 1932292935
Title
President
Phone
(850) 473-0990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X ME49837 FL Primary

Addresses

Primary practice location

17 E Main St
Ste 100
Pensacola, FL 32502-5998

Mailing address

17 E Main St
Ste 100
Pensacola, FL 32502-5998
Phone (850) 473-0990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100910000516 FL Part B Supplier - Clinic/Group Practice 2769507037 Receives reassigned benefits from 1 practitioner
Practice locations: Destin, FL; Pensacola, FL

National Provider Directory

National Provider Directory

Locations

17 E Main St
Ste 100
Pensacola, FL 32502
Phone (850) 473-0990

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1629161633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E MAIN ST",
            "address_2": "STE 100",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025998",
            "telephone_number": "850-473-0990",
            "fax_number": "850-473-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E MAIN ST",
            "address_2": "STE 100",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025998",
            "telephone_number": "850-473-0990",
            "fax_number": "850-473-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC EYE SURGERY ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "PATRINELY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-473-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME49837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.