Optometrica O D P A is a medicare enrolled "Optometrist" provider in Sanibel, Florida. Their current practice location is
1571 Periwinkle Way, Sanibel, Florida. You can reach out to their office (for appointments etc.) via phone at
(239) 560-6917.
Optometrica O D P A is licensed to practice in Florida (license number OPC3502) and it also participates in the medicare program. Optometrica O D P A
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1174879563.
Healthcare Provider's Profile
| Full Name | Optometrica O D P A |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 1571 Periwinkle Way, Sanibel, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1174879563
- Provider Enumeration Date: 08/03/2012
- Last Update Date: 10/01/2012
Medicare PECOS Information:
- PECOS PAC ID: 9638326325
- Enrollment ID: O20120831000454
Medical Identifiers
Medical identifiers for Optometrica O D P A such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174879563 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | OPC3502 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Optometrica O D P A acts as a billing entity for following providers:
| Provider Name | Emilio J Martinez Lezama |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1760464838
PECOS PAC ID: 8022038702
Enrollment ID: I20080701000448 |
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| Provider Name | Phong M. Pham |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1588790828
PECOS PAC ID: 4981756772
Enrollment ID: I20090708000445 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Optometrica O D P A is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Optometrica O D P A
6747 Willow Lake Cir,
Fort Myers, FL 33966-1253
Ph: (239) 560-6917 | Optometrica O D P A
1571 Periwinkle Way,
Sanibel, FL 33957-4513
Ph: (239) 560-6917 |
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