Individual provider Active NPI

Amy E Carlyle, O.D.

  • Optometrist
  • Lutz, FL
National Provider Identifier
1700970522
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6156 Issued in FL
Practice address
24444 Sr 54
Lutz, FL 33559-7303
Phone
(813) 345-8544
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6156 FL Primary
Optometrist 152W00000X 0618000658 VA

Addresses

Primary practice location

24444 Sr 54
Lutz, FL 33559-7303

Mailing address

24444 Sr 54
Lutz, FL 33559-7303
Phone (813) 345-8544

Other practice location 1

8319 Embassy Blvd
Port Richey, FL 34668-5119
Phone (727) 819-0440

Other identifiers 1

IdentifierTypeStateIssuer
9233865MedicaidVA

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
I20241122000959 FL Practitioner - Optometry 2567404197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Walesby Vision Center P aGroup PAC ID 3971718263, 2 clinicians
True Focus Eye Care PAGroup PAC ID 6901931302, 3 clinicians

Practice addresses (Care Compare)

24444 State Rd
Suite 54
Lutz, FL 33559-7303
Phone (813) 345-8544

8319 Embassy Blvd
Port Richey, FL 34668-5119
Phone (727) 819-0440

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6156FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Walesby Vision Center P a CurrentSince Sep 20, 2024 Accepting new patients
Optometric Associates, P. C. Optometrist CurrentSince Aug 3, 1998 Accepting new patients
True Focus Eye Care PA Optometrist CurrentSince Nov 5, 2024 Accepting new patients

Locations

24444 State Road 54
Lutz, FL 33559
Phone (813) 345-8544

8319 Embassy Blvd
Port Richey, FL 34668
Phone (727) 819-0440

8721 Digges Rd
Manassas, VA 20110
Phone (703) 361-4161

Organizations & group practices 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1700970522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24444 SR 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597303",
            "telephone_number": "813-345-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24444 SR 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597303",
            "telephone_number": "813-345-8544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8319 Embassy Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Richey",
            "state": "FL",
            "postal_code": "346685119",
            "country_code": "US",
            "telephone_number": "727-819-0440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6156",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000658",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9233865",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.