Individual provider Active NPI

Mark Fisler, O.D.

  • Optometrist
  • Largo, FL
National Provider Identifier
1689349920
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6002 Issued in FL
Practice address
13002 Seminole Blvd Ste 10&11
Largo, FL 33778-2125
Phone
(727) 333-4100
NPI assigned
Aug 10, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 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 OPC6002 FL Primary

Addresses

Primary practice location

13002 Seminole Blvd Ste 10&11
Largo, FL 33778-2125

Mailing address

1119 Knollwood Dr
Safety Harbor, FL 34695-4407
Phone (727) 458-1888

Other practice location 1

1725 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6507
Phone (239) 800-1717

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
I20211014001507 FL Practitioner - Optometry 6608274014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Sep 13, 2021 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients
Aeshya LLC PastSince Sep 13, 2021 Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

77 N Cattlemen Rd
Sarasota, FL 34243
Phone (941) 893-6109

13002 Seminole Blvd
Seminole, FL 33778
Phone (727) 333-4100

1725 W Mlk Blvd
Tampa, FL 33607
Phone (239) 800-1717

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1689349920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 KNOLLWOOD DR",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954407",
            "telephone_number": "727-458-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13002 SEMINOLE BLVD STE 10&11",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782125",
            "telephone_number": "727-333-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 W Dr Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076507",
            "country_code": "US",
            "telephone_number": "239-800-1717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISLER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.