Individual provider Active NPI

Michael Joseph Chermak, OD

  • Optometrist
  • Tampa, FL
National Provider Identifier
1659094415
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6351 Issued in FL
Practice address
13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446
Phone
(813) 908-2020
Fax
(813) 908-2133
NPI assigned
Sep 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003953 PA
Optometrist 152W00000X OPC6351 FL Primary

Addresses

Primary practice location

13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446

Mailing address

13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446
Phone (813) 908-2020

Other practice location 1

10 Trieble Dr Ste 3
Tunkhannock, PA 18657-7055
Phone (570) 836-2020

Other practice location 2

1111 E End Blvd
Wilkes Barre, PA 18711-0030
Phone (570) 824-3521 ext. 27507

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230112000248 PA Practitioner - Optometry 8820468663 Reassigns benefits to 1 organization
I20230915001054 FL Practitioner - Optometry 8820468663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.55 of 100Reported as group
Quality
99.98
Improvement activities
40
Cost
75.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003953PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Newsom Eye & Laser Center Inc Optometrist CurrentSince Sep 5, 2023 Accepting new patients
Newsom Eye & Laser Center, Inc. Optometrist CurrentSince Sep 5, 2023 Accepting new patients

Locations

14543 Cortez Blvd
Brooksville, FL 34613
Phone (352) 596-4030

4211 US 27 N
Sebring, FL 33870
Phone (863) 385-1544

13904 N Dale Mabry Hwy
Ste 200
Tampa, FL 33618
Phone (813) 908-2020

Interoperability endpoints

  • Direct secure messaging: mchermak@newsomeyelaser.intellechartdirect.net

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": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1659094415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Trieble Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Tunkhannock",
            "state": "PA",
            "postal_code": "186577055",
            "country_code": "US",
            "telephone_number": "570-836-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 E End Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187110030",
            "country_code": "US",
            "telephone_number": "570-824-3521 x27507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERMAK",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003953",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "1111 E End Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187110030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.