Organization Active NPI

Mona Patel OD PA

  • Optometrist
  • Sanford, FL
National Provider Identifier
1891853958
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4046 Issued in FL
Legal business name
MONA PATEL OD PA
Doing business as
Bayhead Eye Centre, OD.
Practice address
820 W Lake Mary Blvd Ste 104
Sanford, FL 32773-5946
Phone
(407) 322-2230
Fax
(407) 330-6287
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Dr. Mona Patel, ODNPI 1487713566
Title
Owner President
Phone
(407) 322-2230

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 OPC 4046 FL Primary

Addresses

Primary practice location

820 W Lake Mary Blvd Ste 104
Sanford, FL 32773-5946

Mailing address

820 W Lake Mary Blvd Ste 104
Sanford, FL 32773-5946
Phone (407) 322-2230

Other identifiers 1

IdentifierTypeStateIssuer
111721000MedicaidFL

Other names 1

  • Bayhead Eye Centre, OD. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080728000730 FL Part B Supplier - Clinic/Group Practice 8820162654 Receives reassigned benefits from 1 practitioner
Practice locations: Sanford, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2277821Mona Patel, OD, PA820 W Lake Mary Blvd #104, Sanford, FL 32773Certificate of waiverMar 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bayhead Eye Centre OD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1891853958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W LAKE MARY BLVD STE 104",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735946",
            "telephone_number": "407-322-2230",
            "fax_number": "407-330-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W LAKE MARY BLVD STE 104",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735946",
            "telephone_number": "407-322-2230",
            "fax_number": "407-330-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONA PATEL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "407-322-2230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111721000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayhead Eye Centre, OD.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.