Individual provider Active NPI

Justin Burtner, OD

  • Optometrist
  • Lakeland, FL
National Provider Identifier
1891159356
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5629 Issued in FL
Practice address
5528 US Highway 98 N
Lakeland, FL 33809-3104
Phone
(863) 853-2020
NPI assigned
Apr 11, 2016
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2102 AZ
Optometrist 152W00000X OPC5629 FL Primary

Addresses

Primary practice location

5528 US Highway 98 N
Lakeland, FL 33809-3104

Mailing address

5528 US Highway 98 N
Lakeland, FL 33809-3104
Phone (863) 853-2020

Other practice location 1

1251 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Phone (863) 687-2260

Other practice location 2

4337 S Florida Ave
Lakeland, FL 33813-1654
Phone (863) 619-2700

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
I20200106001715 FL Practitioner - Optometry 2961701693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
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)

5528 US Hwy 98 N
Lakeland, FL 33809-3104
Phone (863) 853-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5629FLMDOptometrist
2102AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Oct 22, 2019 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Oct 22, 2019 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Past Accepting new patients

Locations

1251 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-2260

4337 S Florida Ave
Lakeland, FL 33813
Phone (863) 619-2700

5528 US Highway 98 N
Lakeland, FL 33809
Phone (863) 294-5457

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

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

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, 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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1891159356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093104",
            "telephone_number": "863-853-2020",
            "fax_number": "863-577-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5528 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093104",
            "telephone_number": "863-853-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054673",
            "country_code": "US",
            "telephone_number": "863-687-2260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4337 S Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338131654",
            "country_code": "US",
            "telephone_number": "863-619-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURTNER",
        "first_name": "JUSTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2102",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.