Kevin Bruce Brantley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3460 Issued in FL

Practice address

1699 N Woodland Blvd
Deland, FL 32720-1803

Phone

(386) 734-2240

Fax

(386) 734-8859

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Charles D Register OD, PAGroup PAC ID 8820206162, 3 clinicians

Coastal Eye Associates Inc.Group PAC ID 8921095092, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beach Vision Holdings, PA

  • Optometrist
  • New Smyrna Beach, FL
  • NPI 1346516747
  Medicare reassignment Care Compare group NPD
• Coastal Eye Associates Inc

  • Optometrist
  • Deland, FL
  • NPI 1356511281
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720123490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 N. WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-734-2240",
            "fax_number": "386-734-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 N WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327201803",
            "telephone_number": "386-734-2240",
            "fax_number": "386-734-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "KEVIN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Boza, MSW
• Jaime Roberto Bracero, PHARMD
• Ivan L Bradley, RPH
• Michelle Bradt, LCSW
• Meghan Flannery Bramlett, LMT
• Brent D. Schlapper
• Kelli Nicole Bridgman, NP
• Bright Beginnings Counseling, PLLC
• Bright Health Inc.
• Beverly Carter Brim, LMHC

• Optometrist in Deland, FL
• Providers in Deland, FL by specialty
• Optometrist in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.