Russell Yale Cooke III, OD DOCTOR OF OPTOMET

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC001729 Issued in FL

Practice address

100 Plumosa Street
Eyeglass World
Merritt Island, FL 32952

Phone

(321) 455-2950

Fax

(321) 455-9719

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Eye Doctors Optical Outlets PA

  • Optometrist
  • Orlando, FL
  • NPI 1164308771
  Medicare reassignment
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Tampa, FL
  • NPI 1114012689
  NPD
• Eye Doctors Optical Outlets, PA

  • Optometrist
  • Saint Cloud, FL
  • NPI 1043721202
  NPD
• Aeg Florida Professional PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1164156246
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992912695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 CARRIAGE COURT",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329032448",
            "telephone_number": "321-777-4400",
            "fax_number": "321-777-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PLUMOSA STREET",
            "address_2": "EYEGLASS WORLD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-455-2950",
            "fax_number": "321-455-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "RUSSELL",
        "middle_name": "YALE",
        "name_suffix": "III",
        "credential": "OD DOCTOR OF OPTOMET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Rene Connell, D.O.M.
• Tara Rae Cooey
• Kayla Cook, DPT
• Stefania Cook, RBT
• Christine M Cooke, P.A.-C
• Olivier Luc Corbeel, PT, MBA
• Cindy Cordero, PHARMD
• Cornerstone Dentistry
• Cornerstone Dentistry Holdings PLLC
• Ali Correa, DDS

• Optometrist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.