Individual provider Active NPI

Madison Lessard Latreille, OD

  • Optometrist
  • Haines City, FL
National Provider Identifier
1689304552
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC006111 Issued in FL
Practice address
119 Patterson Rd
Haines City, FL 33844-7803
Phone
(863) 421-2700
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC006111 FL Primary

Addresses

Primary practice location

119 Patterson Rd
Haines City, FL 33844-7803

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Madison Lessard Former name

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
I20250402003406 FL Practitioner - Optometry 4284157926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

11019 Causeway Blvd
Brandon, FL 33511-1999
Phone (813) 796-5150

1480 Timberlane Rd
Tallahassee, FL 32312-1713
Phone (850) 893-4005

1695 N Broadway Ave
Bartow, FL 33830-3102
Phone (863) 534-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Apr 1, 2025 Accepting new patients
National Vision Inc PastSince Jun 1, 2022 Accepting new patients

Locations

3011 W Yamato Rd
Ste A19
Boca Raton, FL 33434
Phone (561) 995-9600

11019 Causeway Blvd
Brandon, FL 33511
Phone (813) 796-5150

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

119 Patterson Rd
Haines City, FL 33844
Phone (863) 419-1300

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Networks

  • Freedom Health HMO Network

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1689304552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PATTERSON RD",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338447803",
            "telephone_number": "863-421-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSARD LATREILLE",
        "first_name": "MADISON",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC006111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "LESSARD",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.