Austin Taylor, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6526 Issued in FL

Practice address

1100 S Ponce de Leon Blvd Ste 4
Saint Augustine, FL 32084-6013

Phone

(904) 824-0212

NPI assigned

Jun 4, 2024

Last updated

Jul 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1639910649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BELL ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 4",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-824-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "AUSTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaidi Tastet-Ortiz, LCSW
• Ashley Tato
• Bert Anthony Tavary, D.D.S.
• Nicholas Naim Tawil, D.D.S
• Rachel Annette Tax, APRN
• Catherine Noelani Taylor, ED.M
• Tiffany Michelle Taylor, APRN
• Taylored Speech Therapy LLC
• Dalton Teague
• Oscar Antonio Tejeda

• Optometrist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.