Active NPI
Jayeshkumar Patel, O.D.
- Optometrist
- Daytona Beach, FL
National Provider Identifier
1720106750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC0003631
- Practice address
- 2254 W. International Speedway Blvd.
Daytona Beach, FL 32114 - Phone
- (386) 252-3639
- Fax
- (386) 252-0923
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC0003631 | FL | Primary |
Addresses
Primary practice location
2254 W. International Speedway Blvd.
Daytona Beach, FL 32114
Mailing address
4180 Mayfair LN
Port Orange, FL 32129-7506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC0003631 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision, Inc. | Past | Accepting new patients | |
| Gulf Coast Optometry, PA | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Corneal and Contact Management Optometrist
- Tampa, FL
- NPI 1083859409
-
- Eyewear Supplier
- Altamonte Springs, FL
- NPI 1023164886
-
- Eyewear Supplier
- Fort Meyers, FL
- NPI 1477607521
-
- Eyewear Supplier
- Daytona Beach, FL
- NPI 1780738849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720106750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4180 MAYFAIR LN",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321297506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2254 W. INTERNATIONAL SPEEDWAY BLVD.",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "32114",
"telephone_number": "386-252-3639",
"fax_number": "386-252-0923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JAYESHKUMAR",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC0003631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.