Kyle Bettis

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 5258 Issued in FL

Practice address

2254 W International Speedway Blvd
Daytona Beach, FL 32114-1124

Phone

(138) 625-2363

NPI assigned

Jul 28, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Gulf Coast Optometry, PA

  • Corneal and Contact Management Optometrist
  • Tampa, FL
  • NPI 1083859409
  Medicare reassignment NPD
• Qing Ge, M.D., PH.D.

  • Ophthalmology Physician
  • Port Orange, FL
  • NPI 1225053192
  Medicare reassignment
• National Vision, Inc.

  • Eyewear Supplier
  • Altamonte Springs, FL
  • NPI 1023164886
  NPD (past)
• National Vision, Inc.

  • Eyewear Supplier
  • Fort Meyers, FL
  • NPI 1477607521
  NPD (past)
• Premier Eye Clinic

  • Ophthalmology Physician
  • Port Orange, FL
  • NPI 1265718894
  NPD (past)

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1871046565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PRINCE JOHN LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2254 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141124",
            "telephone_number": "138-625-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTIS",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Paul Bernhard Jr., DO
• Bersonn LLC
• Alicia Dionne Betancourt, LCSW
• Marissa E Betancourt
• Bethune-Cookman University
• David Bhola, D.O.
• Darpan Girishkumar Bhuva, M.D.
• Joseph Deverell Bianchi, M.D.
• Mekena Renee Biesinger
• Louis Michael Biga, MD

• Optometrist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.