Individual provider Active NPI

Chad Douglas Hummel, M.D.

  • Ophthalmology Physician
  • Largo, FL
National Provider Identifier
1770877284
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME150884 Issued in FL
Practice address
148 13TH St SW
Largo, FL 33770-3127
Phone
(727) 581-8706
Fax
(727) 588-2447
NPI assigned
Jun 1, 2011
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 283394 NY
Ophthalmology Physician 207W00000X ME150884 FL Primary

Addresses

Primary practice location

148 13TH St SW
Largo, FL 33770-3127

Mailing address

PO Box 2410
Largo, FL 33779-2410
Phone (727) 581-8706

Other identifiers 2

IdentifierTypeStateIssuer
04375339MedicaidNY
114620600MedicaidFL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805007095 FL Practitioner - Ophthalmology 9335367176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Jefferson Medical College of Thomas Jefferson University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3220 N McMullen Booth Rd
Clearwater, FL 33761-2009
Phone (727) 581-8706

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME150884FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Petersburg Outpatient Surgery Center, LLC CurrentSince Feb 17, 2023 Accepting new patients
Aesthetic Center of West Florida LLC Ophthalmology Past Accepting new patients
The Eye Physicians of Pinellas, PA Past Accepting new patients

Locations

6133 Central Ave
St Petersburg, FL 33710
Phone (727) 344-3008

Interoperability endpoints

  • Direct secure messaging: chummel@directaddress.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1770877284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2410",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337792410",
            "telephone_number": "727-581-8706",
            "fax_number": "727-588-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 13TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703127",
            "telephone_number": "727-581-8706",
            "fax_number": "727-588-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "CHAD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "283394",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME150884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04375339",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114620600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.