Grace Sydney Tegenkamp, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC6182 Issued in FL

Practice address

5328 N Davis Hwy
Pensacola, FL 32503-2006

Phone

(850) 434-6387

Fax

(850) 432-0540

NPI assigned

Jan 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

University Alabama Birmingham - School of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

My Eye Guy LLCGroup PAC ID 9931564184, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• My Eye Guy LLC

  • Optometrist
  • Pensacola, FL
  • NPI 1750086971
  Medicare reassignment Care Compare group NPD Authorized official
• Eye Guy Associates of Florida LLC

  • Optometrist
  • Pensacola, FL
  • NPI 1659097418
  Medicare reassignment NPD

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1780399402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5328 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032006",
            "telephone_number": "850-434-6387",
            "fax_number": "850-432-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5328 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032006",
            "telephone_number": "850-434-6387",
            "fax_number": "850-432-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGENKAMP",
        "first_name": "GRACE",
        "middle_name": "SYDNEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Team Adaptive Inc
• Amanda Marie Tech, M.S., CCC- SLP
• Andrea Tedder
• Jessica Tedford, MD
• Tarra Dawn Teeters, ARNP
• Jeffrey Tegenkamp
• Joseph Collin Tegenkamp, OD
• Melissa Padgett Tehranian, LMHC, LMFT
• Keith Templin, PHARMD
• Teodoro K. Ortega, M.D., P.a.

• Optometrist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.