Individual provider Active NPI

Lydia Kate Luther, OD

  • Optometrist
  • Pinellas Park, FL
National Provider Identifier
1629630579
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC005707 Issued in FL
Practice address
6036 Park Blvd N
Pinellas Park, FL 33781-3228
Phone
(727) 895-2020
Fax
(727) 823-8796
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC005707 FL Primary

Addresses

Primary practice location

6036 Park Blvd N
Pinellas Park, FL 33781-3228

Mailing address

1515 9TH Ave N
St Petersburg, FL 33705-1224
Phone (727) 895-2020

Other practice location 1

2650 Tampa Rd Ste A
Palm Harbor, FL 34684-3144
Phone (727) 785-4419

Other practice location 2

1515 9th Ave N
St Petersburg, FL 33705-1224
Phone (727) 895-2020

Other identifiers 1

IdentifierTypeStateIssuer
103786100MedicaidFL

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lluther@gulfcoasteye.intellechartdirect.net
Direct Messaging Address lluther@gulfcoasteye.intellechartdirect.net
Direct Messaging Address lluther@gulfcoasteye.intellechartdirect.net

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190821000314 FL Practitioner - Optometry 0042548653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinellas Eye Care PAGroup PAC ID 3577743996, 11 clinicians

Practice addresses (Care Compare)

1515 9TH Ave N
St Petersburg, FL 33705-1224

2650 Tampa Rd
Suite a
Palm Harbor, FL 34684-3144
Phone (727) 785-4419

6036 Park Blvd N
Gulfcoast Eye Care
Pinellas Park, FL 33781-3228
Phone (727) 549-2105

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC005707FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinellas Eye Care PA Optometrist CurrentSince Mar 19, 2020 Accepting new patients
Pinellas Eye Care PA Optometrist CurrentSince Mar 19, 2020 Accepting new patients
Grillo Monroe Optometry LLC Optometrist Past Accepting new patients
Adept Health & Wellness PastSince Dec 1, 2021 Accepting new patients

Locations

2650 Tampa Rd
Ste A
Palm Harbor, FL 34684
Phone (727) 785-4419

6036 Park Blvd N
Pinellas Park, FL 33781
Phone (727) 549-2105

1515 9th Ave N
St Petersburg, FL 33705
Phone (727) 835-2020

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lluther@gulfcoasteye.intellechartdirect.net

Organizations & group practices 4

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1629630579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 9TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051224",
            "telephone_number": "727-895-2020",
            "fax_number": "727-823-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813228",
            "telephone_number": "727-895-2020",
            "fax_number": "727-823-8796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Tampa Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Palm Harbor",
            "state": "FL",
            "postal_code": "346843144",
            "country_code": "US",
            "telephone_number": "727-785-4419",
            "fax_number": "727-789-3351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 9th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051224",
            "country_code": "US",
            "telephone_number": "727-895-2020",
            "fax_number": "727-823-8796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "LYDIA",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC005707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103786100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lluther@gulfcoasteye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "6036 Park Blvd N",
            "city": "Pinellas Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337813228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lluther@gulfcoasteye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "6036 Park Blvd N",
            "city": "Pinellas Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337813228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lluther@gulfcoasteye.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "1515 9th Ave N",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337051224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.