Individual provider Active NPI

Sandra J Spender, O.D.

  • Optometrist
  • Atlantis, FL
National Provider Identifier
1891837340
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2962 Issued in FL
Practice address
204 Walton Heath Dr
Atlantis, FL 33462-1128
Phone
(561) 310-2480
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2962 FL Primary

Addresses

Primary practice location

204 Walton Heath Dr
Atlantis, FL 33462-1128

Mailing address

204 Walton Heath Dr
Atlantis, FL 33462-1128
Phone (561) 310-2480

Other identifiers 2

IdentifierTypeStateIssuer
967721OtherFLEYEMED PROVIDER NUMBER
14360OtherFLDAVIS VISION NUMBER

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
I20200408002057 FL Practitioner - Optometry 6507295151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Sandra J Spender P.a. Optometrist CurrentSince Jan 25, 2020 Accepting new patients
Erickson Costello Butler Erickson Optometrist PA Optometrist PastSince Nov 10, 1999 Accepting new patients

Locations

17800 Congress Ave
Boca Raton, FL 33487
Phone (561) 758-2030

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891837340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 WALTON HEATH DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621128",
            "telephone_number": "561-310-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 WALTON HEATH DR",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621128",
            "telephone_number": "561-310-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENDER",
        "first_name": "SANDRA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED PROVIDER NUMBER",
            "identifier": "967721",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION NUMBER",
            "identifier": "14360",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.