Individual provider Active NPI

Andrea Marissa Zeitlin, O.D.

  • Optometrist
  • Tampa, FL
National Provider Identifier
1770660029
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3964 Issued in FL
Practice address
2266 University Square Mall
Tampa, FL 33612-5518
Phone
(813) 978-3263
Fax
(813) 977-0660
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3964 FL Primary

Addresses

Primary practice location

2266 University Square Mall
Tampa, FL 33612-5518

Mailing address

9420 Georgian Park LN Apt 102
Tampa, FL 33626-5179
Phone (941) 228-1373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea Zeitlin OD PA Optometrist Current Accepting new patients
Luxottica of America Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: andrea.zeitlin.1@18455.direct.athenahealth.com

Organizations & group practices 2

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770660029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 GEORGIAN PARK LN APT 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336265179",
            "telephone_number": "941-228-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 UNIVERSITY SQUARE MALL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125518",
            "telephone_number": "813-978-3263",
            "fax_number": "813-977-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEITLIN",
        "first_name": "ANDREA",
        "middle_name": "MARISSA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.