Individual provider Active NPI

Roger Paez, O.D.

  • Optometrist
  • Naples, FL
National Provider Identifier
1750428561
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5150 Issued in FL
Practice address
2500 Goodlette-Frank Rd N Unit 200
Naples, FL 34103-4607
Phone
(239) 418-0999
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5150 FL Primary
Optometrist 152W00000X 507 NV

Addresses

Primary practice location

2500 Goodlette-Frank Rd N Unit 200
Naples, FL 34103-4607

Mailing address

12731 New Brittany Blvd
Fort Myers, FL 33907-3632
Phone (239) 418-0999

Other practice location 1

9617 Gulf Research Ln
Fort Myers, FL 33912-4560
Phone (239) 418-0999

Other identifiers 2

IdentifierTypeStateIssuer
015917600MedicaidFL
OPC5150OtherFLFLORIDA LICENSE

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
I20160302000286 FL Practitioner - Optometry 0244293934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jonathan M Frantz, MD PAGroup PAC ID 9234039140, 25 clinicians

Practice addresses (Care Compare)

12731 New Brittany Blvd
Fort Myers, FL 33907-3632
Phone (239) 418-0999

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
507NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wonchon Lin, M.D., PLLC CurrentSince Dec 1, 2019 Accepting new patients
Jonathan M Frantz, MD PA CurrentSince Jan 4, 2016 Accepting new patients
Paez & Yontz OD PA Optometrist Current Accepting new patients
Jonathan M Frantz, MD PA Past Accepting new patients
Jonathan M Frantz, MD PA Past Accepting new patients
Jonathan M Frantz, MD PA PastSince Feb 18, 2024 Accepting new patients

Locations

3515 Del Prado Blvd S
Ste 104
Cape Coral, FL 33904
Phone (239) 542-4123

12731 New Brittany Blvd
Fort Myers, FL 33907
Phone (941) 418-0999

3020 Lee Blvd
Lehigh Acres, FL 33971
Phone (239) 369-2010

7075 Radio Rd
Naples, FL 34104
Phone (239) 455-4500

2500 Goodlette-Frank Rd N
Naples, FL 34103
Phone (239) 430-3939

109 Taylor St
Punta Gorda, FL 33950
Phone (941) 505-2020

9617 Gulf Research Ln
South Fort Myers, FL 33912
Phone (239) 418-0262

2580 S Decatur Blvd
Ste 6
Las Vegas, NV 89102
Phone (702) 570-2820

Organizations & group practices 6

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1750428561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12731 NEW BRITTANY BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073632",
            "telephone_number": "239-418-0999",
            "fax_number": "239-418-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 GOODLETTE-FRANK RD N UNIT 200",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341034607",
            "telephone_number": "239-418-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9617 Gulf Research Ln",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124560",
            "country_code": "US",
            "telephone_number": "239-418-0999",
            "fax_number": "239-418-0091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAEZ",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5150",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015917600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "OPC5150",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.