NPIMap

Organization Active NPI

Eye Center of North Florida, P.a.

  • Optometrist
  • Panama City, FL
National Provider Identifier
1740213529
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CENTER OF NORTH FLORIDA, P.A.
Practice address
2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412
Phone
(850) 784-3937
Fax
(850) 522-9829
NPI assigned
Jul 8, 2006
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Dr. Bret L Fisher, M.D.
Title
President
Phone
(850) 784-3937

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X
Optometrist 152W00000X Primary
Corneal and Contact Management Optometrist 152WC0802X
Low Vision Rehabilitation Optometrist 152WL0500X
Pediatric Optometrist 152WP0200X
Ophthalmology Physician 207W00000X
Occupational Therapist 225X00000X

Addresses

Primary practice location

2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412

Mailing address

2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412
Phone (850) 784-3937

Other identifiers 3

IdentifierTypeStateIssuer
257952900MedicaidFL
45154OtherFLBLUE CROSS & BLUE SHIELD
CG6943OtherFLRR MEDICARE

Other names 1

  • Eye Center Of North Florida Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050719000831 FL Part B Supplier - Clinic/Group Practice 0042247306 Receives reassigned benefits from 8 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chipley, FL; Panama City, FL; Panama City Beach, FL
O20100930018155 FL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 0042247306 Practice locations: Panama City, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eye Center of North Florida5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2500 Martin Luther King Jr Blvd
Panama City, FL 32405
Phone (850) 522-7951

Interoperability endpoints

  • Direct secure messaging: aozkok@especnf.intellechartdirect.net
  • Direct secure messaging: asarver@especnf.intellechartdirect.net
  • Direct secure messaging: denfield@especnf.intellechartdirect.net
  • Direct secure messaging: gpeters@especnf.intellechartdirect.net
  • Direct secure messaging: jtokarev@especnf.intellechartdirect.net
  • Direct secure messaging: llong@especnf.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1740213529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054412",
            "telephone_number": "850-784-3937",
            "fax_number": "850-522-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054412",
            "telephone_number": "850-784-3937",
            "fax_number": "850-522-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF NORTH FLORIDA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-784-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257952900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "45154",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG6943",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Center Of North Florida",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Eye Center Of North Florida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.