Individual provider Active NPI

Ilira Caboku, OD

  • Optometrist
  • Tampa, FL
National Provider Identifier
1962245159
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6501 Issued in FL
Practice address
13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446
Phone
(813) 908-2020
NPI assigned
Jun 14, 2024
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6501 FL Primary

Addresses

Primary practice location

13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446

Mailing address

2415 Timbercrest Cir E
Clearwater, FL 33763-1621

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
I20241003003903 FL Practitioner - Optometry 3375074180 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6501FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearle Capstone Eye Associates, PLLC Optometrist CurrentSince Jul 27, 2024 Accepting new patients

Locations

13555 Highway 54
Ste C
Odessa, FL 33556
Phone (813) 454-0670

7855 113th St
Ste A
Seminole, FL 33772
Phone (727) 317-6174

1601 NW Expressway
Ste 1420
Oklahoma City, OK 73118

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1962245159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 TIMBERCREST CIR E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABOKU",
        "first_name": "ILIRA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-07-29",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.