Individual provider Active NPI

Stephen Gres, O.D.

  • Optometrist
  • Valrico, FL
National Provider Identifier
1962528620
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2050 Issued in FL
Practice address
2547 State Road 60 E
Valrico, FL 33594-3830
Phone
(813) 653-9661
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 OPC2050 FL Primary

Addresses

Primary practice location

2547 State Road 60 E
Valrico, FL 33594-3830

Mailing address

2547 State Road 60 E
Valrico, FL 33594-3830
Phone (813) 653-9661

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
I20040607000155 FL Practitioner - Optometry 7719969336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2050FLMDOptometrist
2050FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jul 20, 2021 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Jul 20, 2021 Accepting new patients
Maxim-Eyes Optical, Inc Optometrist CurrentSince Sep 25, 2018 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients

Locations

937 Brandon Town Center Mall
Brandon, FL 33511
Phone (813) 685-1935

4121 US Highway 98 N
Ste A140
Lakeland, FL 33809

3654 Harden Blvd
Lakeland, FL 33803
Phone (813) 644-7242

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

2547 E State Road 60
Valrico, FL 33594
Phone (813) 653-9661

2615 E State Road 60
Valrico, FL 33594
Phone (813) 653-9661

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962528620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2547 STATE ROAD 60 E",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335943830",
            "telephone_number": "813-653-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2547 STATE ROAD 60 E",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335943830",
            "telephone_number": "813-653-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRES",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.