Active NPI
David A Roberts, OD
- Optometrist
- Lakeland, FL
National Provider Identifier
1972665883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC2385
- Practice address
- 1251 Lakeland Hills Blvd
Lakeland, FL 33805-4673 - Phone
- (863) 687-2260
- Fax
- (863) 595-0927
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | OPC2385 | FL | |
| Optometrist | 152W00000X | 8843-T | CA | |
| Optometrist | 152W00000X | OPC2385 | FL | Primary |
Addresses
Primary practice location
1251 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Mailing address
1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11840789 | Other | CAQH | |
| V12404 | Other | UPIN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4121 US 98
Lakeland, FL 33809-3818
Phone (863) 859-7100
5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8843-T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Doctors Optical Outlets PA | Optometrist | Current | Accepting new patients |
| Eye Doctors Optical Outlets PA | Optometrist | Current | Accepting new patients |
| Jwang Medical Group, Inc. | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients | |
| El Camino Hospital | Past | Accepting new patients | |
| Studio Optics Optometric Group, Inc. | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients |
Locations
5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873
Networks
- Freedom Health HMO Network
Organizations & group practices 7
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.
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- NPI 1023164886
-
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- NPI 1477607521
-
- General Acute Care Hospital
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- NPI 1093712374
-
- Ophthalmology Physician
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- NPI 1255431078
-
- Ophthalmology Physician
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- NPI 1083617302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460160000000",
"number": "1972665883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 OLD GALLOWS RD",
"address_2": "SUITE 520",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823990",
"telephone_number": "703-847-8899",
"fax_number": "703-991-0514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338054673",
"telephone_number": "863-687-2260",
"fax_number": "863-595-0927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DAVID",
"middle_name": "A",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2016-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "FL",
"license": "OPC2385",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "8843-T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC2385",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11840789",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "V12404",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2016; 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.