Individual provider Active NPI

Alexandra Vlad

  • Optometrist
  • The Villages, FL
National Provider Identifier
1710447917
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5639 Issued in FL
Practice address
1050 Old Camp Rd
The Villages, FL 32162-1762
Phone
(352) 626-1450
Fax
(352) 626-1395
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5639 FL Primary

Addresses

Primary practice location

1050 Old Camp Rd
The Villages, FL 32162-1762

Mailing address

1050 Old Camp Rd
The Villages, FL 32162-1762
Phone (352) 626-1450

Other practice location 1

1128 Bichara Blvd
Lady Lake, FL 32159-7716
Phone (352) 750-2414

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
I20200623002759 FL Practitioner - Optometry 3870915705 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jul 23, 2022 Accepting new patients
Lakeview Healthcare System, LLC CurrentSince May 24, 2021 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jul 23, 2022 Accepting new patients
Lakeview Healthcare System, LLC CurrentSince May 24, 2021 Accepting new patients

Locations

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

410 Fern Dr
Leesburg, FL 34748
Phone (352) 218-8200

1801 US Highway 441
Bldg 100
Leesburg, FL 34748
Phone (352) 460-4004

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

10250 SE 167th Place Rd
Unit 5
Summerfield, FL 34491
Phone (352) 307-9225

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

1128 Bichara Blvd
The Villages, FL 32159
Phone (352) 750-2414

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1710447917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-626-1450",
            "fax_number": "352-626-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OLD CAMP RD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321621762",
            "telephone_number": "352-626-1450",
            "fax_number": "352-626-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1128 Bichara Blvd",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321597716",
            "country_code": "US",
            "telephone_number": "352-750-2414",
            "fax_number": "352-259-4286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VLAD",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.