Anisa Kristollari, OPTOMETRY DOCTOR

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4633 Issued in FL

Practice address

4413 Lyons Rd. Promenade Eye Care
Ste 101 Next to Lenscrafters Optique
Coconut Creek, FL 33073

Phone

(954) 975-9181

Fax

(954) 975-9597

NPI assigned

Aug 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promenade Eye Care, LLCGroup PAC ID 0143747329, 2 clinicians

Practice addresses (Care Compare)

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.

• Promenade Eye Care, LLC

  • Optometrist
  • Coconut Creek, FL
  • NPI 1225457716
  Medicare reassignment Care Compare group NPD Authorized official
• South Florida Vision Services, Inc.

  • Optometrist
  • Fort Lauderdale, FL
  • NPI 1912032566
  NPD (past)

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752883200000",
    "number": "1760762769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 LYONS RD. PROMENADE EYE CARE",
            "address_2": "STE 101 NEXT TO LENSCRAFTERS OPTIQUE",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "33073",
            "telephone_number": "954-975-9181",
            "fax_number": "954-975-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 LYONS RD. PROMENADE EYE CARE",
            "address_2": "STE 101 NEXT TO LENSCRAFTERS OPTIQUE",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "33073",
            "telephone_number": "954-975-9181",
            "fax_number": "954-975-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTOLLARI",
        "first_name": "ANISA",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRY DOCTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6051/T2966",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA OPTOMETRY LICENSE",
            "identifier": "OPC 4633",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisha Deborah Koota, A.P.
• Paul C Kopp
• Myron David Koris, M.D.
• Jeffrey Warren Kotter, CRTT
• Morgan Kramer, MS
• Amy Cheryl Krostich, CPNP
• Jeffrey M Kupiec, RPH
• Dean Andrew Lagala, PHARM.D.
• Juliana Marie Lamanna
• Deborah Nancy Lamb

• Optometrist in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.