Individual provider Active NPI

Rebecca R Matchok, O.D.

  • Optometrist
  • Bradenton, FL
National Provider Identifier
1740285659
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3025 Issued in FL
Practice address
5315 Cortez Rd W
Vision Center
Bradenton, FL 34210-2814
Phone
(941) 761-7373
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3025 FL Primary

Addresses

Primary practice location

5315 Cortez Rd W
Vision Center
Bradenton, FL 34210-2814

Mailing address

PO Box 434
Palmetto, FL 34220-0434
Phone (941) 761-7373

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
I20111107000637 FL Practitioner - Optometry 8527231547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3025FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kurt Lotspeich, O.D., P.a. Optometrist Past Accepting new patients
Palm Coast Eye Center, P.a. Optometrist Past Accepting new patients
Palm Coast Eyewear, LLC Past Accepting new patients

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1740285659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 434",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342200434",
            "telephone_number": "941-761-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 CORTEZ RD W",
            "address_2": "VISION CENTER",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102814",
            "telephone_number": "941-761-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATCHOK",
        "first_name": "REBECCA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.