Jordan Paul Petrosky, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5530 Issued in FL

Practice address

10000 Bay Pines Blvd
Bay Pines, FL 33744-8200

Phone

(727) 398-6661

NPI assigned

Jun 10, 2018

Sex

Male

Sole proprietor

Yes

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

Specialty

Optometry

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Troy L Bedinghaus OD PAGroup PAC ID 4587731559, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Troy L Bedinghaus OD PA

  • Optometrist
  • Lakewood Ranch, FL
  • NPI 1760661177
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1942793484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11151 STATE ROAD 70 E",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342028405",
            "telephone_number": "941-739-5959",
            "fax_number": "941-756-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7614 Citrus Blossom Dr",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346377470",
            "country_code": "US",
            "telephone_number": "941-276-4978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETROSKY",
        "first_name": "JORDAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-10",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homer Tariao Pelayo, M.D.
• Simon Francis Pels
• Amanda Renee Pennington, M.D.
• Autumn Kapua Eakin Perry, PHARMD
• James John Peterfeso, CRNA
• Kiara Pettus, MSW
• Austin Butler Pierce
• Shinelle T Pierre, PHARMD
• Kelly Johanna Pires
• David Ihsan Pirro, AGNP-C

• Optometrist in Bay Pines, FL
• Providers in Bay Pines, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.
• 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.