Individual provider Active NPI

Ronald Konrad Kittl, O.D.

  • Optometrist
  • Clearwater, FL
National Provider Identifier
1689733354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP0001938 Issued in FL
Practice address
27001 US Highway 19 N
Clearwater, FL 33761-3402
Phone
(727) 725-7432
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP0001938 FL Primary

Addresses

Primary practice location

27001 US Highway 19 N
Clearwater, FL 33761-3402

Mailing address

1529 Chukar RDG
Palm Harbor, FL 34683-6455
Phone (727) 734-4511

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
I20031229000898 FL Practitioner - Optometry 0547168544 Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP0001938FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689733354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 CHUKAR RDG",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346836455",
            "telephone_number": "727-734-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27001 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613402",
            "telephone_number": "727-725-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTL",
        "first_name": "RONALD",
        "middle_name": "KONRAD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0001938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.