Individual provider Active NPI

Sierra Logan, OD

  • Optometrist
  • Leesburg, FL
National Provider Identifier
1831877406
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6333 Issued in FL
Practice address
1320 Shelfer St
Leesburg, FL 34748-3929
Phone
(352) 728-8318
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6333 FL Primary

Addresses

Primary practice location

1320 Shelfer St
Leesburg, FL 34748-3929

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442

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
I20230831000124 FL Practitioner - Optometry 1951764422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

1128 Bichara Blvd
Lady Lake, FL 32159-7716
Phone (352) 750-2414

1320 Shelfer St
Leesburg, FL 34748-3929
Phone (352) 728-8318

2140 Crawfordville Hwy
Crawfordville, FL 32327-1009
Phone (850) 926-9213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Aug 21, 2023 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Aug 21, 2023 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Past Accepting new patients

Locations

3011 W Yamato Rd
Ste A19
Boca Raton, FL 33434
Phone (561) 995-9600

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

1320 Shelfer St
Leesburg, FL 34748
Phone (352) 728-8318

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

1128 Bichara Blvd
The Villages, FL 32159
Phone (352) 750-2414

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1831877406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SHELFER ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483929",
            "telephone_number": "352-728-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "SIERRA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.