Individual provider Active NPI

Samuel Kenney Houston III, MD

  • Ophthalmology Physician
  • Orlando, FL
National Provider Identifier
1851533236
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME123038 Issued in FL
Practice address
95 Columbia St
Orlando, FL 32806-1101
Phone
(407) 849-9621
Fax
(407) 420-4056
NPI assigned
Mar 31, 2009
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME123038 FL Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X ME123038 FL

Addresses

Primary practice location

95 Columbia St
Orlando, FL 32806-1101

Mailing address

95 Columbia St
Orlando, FL 32806-1101
Phone (407) 849-9621

Other practice location 1

790 S Highway 27 / 441
Lady Lake, FL 32159-4540
Phone (352) 259-9944

Other practice location 2

4880 N Highway 19A Ste 100
Mount Dora, FL 32757-2018
Phone (352) 357-1203

Other practice location 3

2270 E Highway 50
Clermont, FL 34711-6052
Phone (352) 243-0716

Other practice location 4

1123 N Central Ave
Kissimmee, FL 34741-4405
Phone (407) 847-7915

Other identifiers 1

IdentifierTypeStateIssuer
015132500MedicaidFL

Other names 1

  • Samuel K. Steven Houston III Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shouston@floridaretinainstitute.intellechartdirect.net

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526001643 FL Practitioner - Ophthalmology 0143462085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Virginia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Vitreous ConsultantsGroup PAC ID 4082610019, 43 clinicians

Practice addresses (Care Compare)

95 Columbia St
Orlando, FL 32806-1101
Phone (407) 849-9621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Vitreous Consultants Ophthalmology CurrentSince Oct 1, 2023 Accepting new patients
Weoc ER Inc Ophthalmology Past Accepting new patients

Locations

950 Glades Rd
Ste 1C
Boca Raton, FL 33431
Phone (305) 294-5504

2270 E Highway 50
Clermont, FL 34711
Phone (352) 243-0716

2639 Oak St
Jacksonville, FL 32204
Phone (904) 387-5600

8786 Perimeter Park Blvd
Jacksonville, FL 32216
Phone (904) 997-9202

2921 Park Pond Way
Kissimmee, FL 34741
Phone (407) 847-7915

1025 Primera Blvd
Lake Mary, FL 32746
Phone (407) 333-1570

4880 N Highway 19A
Ste 100
Mount Dora, FL 32757
Phone (352) 357-1203

95 Columbia St
Orlando, FL 32806
Phone (407) 849-9621

50 Leanni Way
Unit E5
Palm Coast, FL 32137
Phone (386) 447-1847

1370 E Venice Ave
Ste 201
Venice, FL 34285
Phone (941) 480-0500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1851533236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061101",
            "telephone_number": "407-849-9621",
            "fax_number": "407-367-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061101",
            "telephone_number": "407-849-9621",
            "fax_number": "407-420-4056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 S Highway 27 / 441",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321594540",
            "country_code": "US",
            "telephone_number": "352-259-9944",
            "fax_number": "352-259-9926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4880 N Highway 19A Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mount Dora",
            "state": "FL",
            "postal_code": "327572018",
            "country_code": "US",
            "telephone_number": "352-357-1203",
            "fax_number": "352-357-1459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2270 E Highway 50",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347116052",
            "country_code": "US",
            "telephone_number": "352-243-0716",
            "fax_number": "352-243-0717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1123 N Central Ave",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414405",
            "country_code": "US",
            "telephone_number": "407-847-7915",
            "fax_number": "407-847-7921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "SAMUEL",
        "middle_name": "KENNEY",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME123038",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME123038",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015132500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shouston@floridaretinainstitute.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "95 Columbia St",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328061101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "HOUSTON",
            "middle_name": "K. STEVEN",
            "suffix": "III",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.