Individual provider Active NPI

John E Witkowski, O.D.

  • Optometrist
  • Naples, FL
National Provider Identifier
1821037409
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC002142 Issued in FL
Practice address
5959 Pine Ridge Rd
Naples, FL 34119-3955
Phone
(239) 262-4662
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC002142 FL Primary

Addresses

Primary practice location

5959 Pine Ridge Rd
Naples, FL 34119-3955

Mailing address

33 Shores Ave
Naples, FL 34110-1607
Phone (239) 591-3283

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
I20060919000465 FL Practitioner - Optometry 4789689050 Practice locations: Naples, FL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5959 Pine Ridge Rd
Naples, FL 34119-3955
Phone (239) 262-4662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC002142FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1821037409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SHORES AVE",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101607",
            "telephone_number": "239-591-3283",
            "fax_number": "239-353-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193955",
            "telephone_number": "239-262-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKOWSKI",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC002142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.