Organization Active NPI

Florida Eye Clinic P a

  • Optometrist
  • Winter Springs, FL
National Provider Identifier
1992770176
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FLORIDA EYE CLINIC P A
Practice address
5727 Canton CV
#111
Winter Springs, FL 32708-5033
Phone
(407) 695-2020
Fax
(407) 699-5666
NPI assigned
Feb 21, 2006
Organization subpart
Yes
Parent organization
FLORIDA EYE CLINIC P AAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Authorized official

Name
Harry Pappas
Title
Administrator
Phone
(407) 834-7776

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5727 Canton CV
#111
Winter Springs, FL 32708-5033

Mailing address

160 Boston Ave
Altamonte Springs, FL 32701-4706
Phone (407) 339-0303

Other identifiers 1

IdentifierTypeStateIssuer
208488107MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000005 FL Part B Supplier - Clinic/Group Practice 6406758846 Receives reassigned benefits from 37 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winter Springs, FL; Windermere, FL; Ormond Beach, FL; Orlando, FL; Orange City, FL; Ocoee, FL; Kissimmee, FL; Clermont, FL…

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Florida Eye Clinic P a5727 Canton CV, Winter Springs, FL 32708-5033(407) 695-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Part of
Thomas D Mauger OD

Locations

5727 Canton Cv
Ste 111
Winter Springs, FL 32708
Phone (407) 695-2020

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1992770176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BOSTON AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014706",
            "telephone_number": "407-339-0303",
            "fax_number": "407-339-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5727 CANTON CV",
            "address_2": "#111",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085033",
            "telephone_number": "407-695-2020",
            "fax_number": "407-699-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA EYE CLINIC P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA EYE CLINIC P A",
        "enumeration_date": "2006-02-21",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-834-7776"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208488107",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.