Organization Active NPI

Bayhead Eye Centre

  • Optometrist
  • Sanford, FL
National Provider Identifier
1700807682
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPL1438 Issued in FL
Legal business name
BAYHEAD EYE CENTRE
Practice address
820 W Lake Mary Blvd
Suite # 104
Sanford, FL 32773-5946
Phone
(407) 322-2230
Fax
(407) 330-6287
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Dr. Mona Patel, O.D.NPI 1487713566
Title
Owner/President
Phone
(407) 322-2230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPL1438 FL Primary

Addresses

Primary practice location

820 W Lake Mary Blvd
Suite # 104
Sanford, FL 32773-5946

Mailing address

820 W Lake Mary Blvd
Suite # 104
Sanford, FL 32773-5946
Phone (407) 322-2230

Other identifiers 2

IdentifierTypeStateIssuer
078034100MedicaidFL
OPL1438OtherFLLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101027000356 FL Part B Supplier - Clinic/Group Practice 2769676402 Receives reassigned benefits from 1 practitioner
Practice locations: Sanford, FL

National Provider Directory

National Provider Directory

Locations

820 W Lake Mary Blvd
Ste 104
Sanford, FL 32773
Phone (407) 322-2230

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1700807682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W LAKE MARY BLVD",
            "address_2": "SUITE # 104",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735946",
            "telephone_number": "407-322-2230",
            "fax_number": "407-330-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W LAKE MARY BLVD",
            "address_2": "SUITE # 104",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735946",
            "telephone_number": "407-322-2230",
            "fax_number": "407-330-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYHEAD EYE CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "407-322-2230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPL1438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078034100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "OPL1438",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.