Individual provider Active NPI

Stacey P Goldstein, O.D.

  • Optometrist
  • Tampa, FL
National Provider Identifier
1841523677
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4440 Issued in FL
Practice address
1512-A East Fowler Ave
Tampa, FL 33612-5416
Phone
(813) 971-0471
Fax
(813) 971-5864
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4440 FL Primary

Addresses

Primary practice location

1512-A East Fowler Ave
Tampa, FL 33612-5416

Mailing address

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 885-3937

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
I20091109000188 FL Practitioner - Optometry 7315085586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873

6431 E County Line Rd
Suite 113
Tampa, FL 33647-1840
Phone (813) 315-3085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4440FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Aug 31, 2009 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Aug 31, 2009 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients

Locations

1512 E Fowler Ave
Ste A
Tampa, FL 33612
Phone (813) 971-0471

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

6417 E County Line Rd
Ste 102
Tampa, FL 33647
Phone (813) 315-3085

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1841523677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5607 JOHNS RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336344499",
            "telephone_number": "813-885-3937",
            "fax_number": "813-884-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512-A EAST FOWLER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125416",
            "telephone_number": "813-971-0471",
            "fax_number": "813-971-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "STACEY",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.