NPIMap

Organization Active NPI

Pearle Capstone Eye Associates, PLLC

Doing business as Pearle Vision - Odessa

  • Optometrist
  • Odessa, FL
National Provider Identifier
1841925849
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PEARLE CAPSTONE EYE ASSOCIATES, PLLC
Doing business as
Pearle Vision - Odessa
Practice address
13555 FL 54 Suite C
Odessa, FL 33556
Phone
(813) 454-0670
Fax
(813) 730-8090
NPI assigned
Jul 22, 2022
Organization subpart
Yes
Parent organization
PEARLE CAPSTONE EYE ASSOCIATES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Allison Dickson, ODNPI 1528547031
Title
Ambr
Phone
(616) 717-1634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

13555 FL 54 Suite C
Odessa, FL 33556

Mailing address

1601 NW Expressway Ste 1420
Oklahoma City, OK 73118-1460
Phone (405) 438-0345

Other names 1

  • Pearle Vision - Odessa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221017000044 FL Part B Supplier - Clinic/Group Practice 1951777929 Receives reassigned benefits from 18 practitioners
Practice locations: Lutz, FL; Tampa, FL; Seminole, FL; Saint Petersburg, FL; Odessa, FL; Clearwater, FL

National Provider Directory

National Provider Directory
Tax ID family
Pearle Capstone Eye Associates PLLC7 organizations share this tax ID, including this one
Part of
Pearle Capstone Eye Associates PLLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13555 Highway 54
Ste C
Odessa, FL 33556
Phone (813) 454-0670

13555 Sr 54
Odessa, FL 33556

7855 113th St
Ste A
Seminole, FL 33772
Phone (727) 317-6174

8504 Citrus Park Dr
Tampa, FL 33625
Phone (813) 514-9220

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1841925849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 NW EXPRESSWAY STE 1420",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181460",
            "telephone_number": "405-438-0345",
            "fax_number": "405-353-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 FL 54 SUITE C",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "33556",
            "telephone_number": "813-454-0670",
            "fax_number": "813-730-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLE CAPSTONE EYE ASSOCIATES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEARLE CAPSTONE EYE ASSOCIATES PLLC",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "616-717-1634",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision - Odessa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pearle Vision - Odessa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.