Individual provider Active NPI

Tulsi Patel, OD

  • Optometrist
  • Port Saint Lucie, FL
National Provider Identifier
1750154092
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6361 Issued in FL
Practice address
1477 North West Port Saint Lucie West Boulevard
Suite 105
Port Saint Lucie, FL 34986
Phone
(772) 446-8715
NPI assigned
Oct 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6361 FL Primary

Addresses

Primary practice location

1477 North West Port Saint Lucie West Boulevard
Suite 105
Port Saint Lucie, FL 34986

Mailing address

5410 NW Milner Dr
Port Saint Lucie, FL 34983-3372

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
I20240314002099 FL Practitioner - Optometry 0648616466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6361FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Jan 30, 2024 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision Inc PastSince Nov 5, 2023 Accepting new patients

Locations

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

Networks

  • Freedom Health HMO Network

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": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1750154092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 NW MILNER DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349833372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 NORTH WEST PORT SAINT LUCIE WEST BOULEVARD",
            "address_2": "SUITE 105",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-446-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TULSI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.