Individual provider Active NPI

Vrunda Manishkumar Patel, OD

  • Optometrist
  • Bartow, FL
National Provider Identifier
1689564940
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6789 Issued in FL
Practice address
1050 E Van Fleet Dr
Bartow, FL 33830-7603
Phone
(863) 617-0736
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 6789 FL Primary

Addresses

Primary practice location

1050 E Van Fleet Dr
Bartow, FL 33830-7603

Mailing address

3079 Panther Dr
Lakeland, FL 33812-5124
Phone (863) 617-0736

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
I20251029000134 FL Practitioner - Optometry 5496244618 Reassigns benefits to 1 organization
Practice locations: Bartow, FL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1050 E Van Fleet Dr
Bartow, FL 33830-7603
Phone (863) 617-0736

3079 Panther Dr
Lakeland, FL 33812-5124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6789FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optomeyez Vision LLC Optometrist CurrentSince Jul 18, 2025 Accepting new patients

Locations

1050 E Van Fleet Dr
Bartow, FL 33830
Phone (863) 268-5857

Organizations & group practices 1

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1689564940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3079 PANTHER DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338125124",
            "telephone_number": "863-617-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E VAN FLEET DR",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338307603",
            "telephone_number": "863-617-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VRUNDA",
        "middle_name": "MANISHKUMAR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

Verify at the official NPI Registry.