Individual provider Active NPI

Anthony L. Stubits, O.D.

  • Optometrist
  • Fernandina Beach, FL
National Provider Identifier
1659458388
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1785 Issued in FL
Practice address
6 South 14TH Street
Fernandina Beach, FL 32034
Phone
(904) 261-5741
Fax
(904) 261-7383
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1001 GA
Optometrist 152W00000X 1785 FL Primary

Addresses

Primary practice location

6 South 14TH Street
Fernandina Beach, FL 32034

Mailing address

6 South 14TH Street
Fernandina Beach, FL 32034
Phone (904) 261-5741

Other identifiers 3

IdentifierTypeStateIssuer
0254141BMedicaidGA
000254141CMedicaidGA
0782262MedicaidFL

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
I20120207000184 FL Practitioner - Optometry 5496830986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russell Stackhouse MD PAGroup PAC ID 9133473325, 13 clinicians

Practice addresses (Care Compare)

6 S 14TH St
Fernandina, FL 32034-3212
Phone 9042615741134

Merit-based Incentive Payment System (MIPS)

Final score
92.84 of 100Reported as group
Quality
85.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001GAMDMarriage & Family Therapist
1785FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Stackhouse MD PA CurrentSince Jul 14, 2018 Accepting new patients
South Florida Vision Services, Inc. Optometrist PastSince Aug 23, 2019 Accepting new patients
Brian S Armitage, O.D., P.a. Past Accepting new patients
Vision Masters, P.C. Optometrist PastSince Aug 1, 2006 Accepting new patients

Locations

6 S 14th St
Fernandina Beach, FL 32034
Phone (904) 261-5741

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1659458388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SOUTH 14TH STREET",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "32034",
            "telephone_number": "904-261-5741",
            "fax_number": "904-261-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SOUTH 14TH STREET",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "32034",
            "telephone_number": "904-261-5741",
            "fax_number": "904-261-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBITS",
        "first_name": "ANTHONY",
        "middle_name": "L.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1001",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "1785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0254141B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000254141C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0782262",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.