ST. JUDE MEDICAL CENTER & AESTHETIC CARE
NPI 1518260090
Ophthalmology in Brandon, FL
NPI Status: Active since December 06, 2010
Contact Information
131 N MOON AVE
SUITES 3 & 4
BRANDON, FL
ZIP 33510
Phone: (813) 315-9898
Fax: (813) 438-5967
- Organization
- Ophthalmology
- CLIA Number: 10D2025474
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-06-2026
About ST. JUDE MEDICAL CENTER & AESTHETIC CARE
This page provides the complete NPI Profile along with additional information for St. Jude Medical Center & Aesthetic Care, a provider established in Brandon, Florida operating as a Ophthalmology. The healthcare provider is registered in the NPI registry with number 1518260090 assigned on December 2010. The practitioner's primary taxonomy code is 207W00000X with license number ME107980 (FL). The provider is registered as an organization and their NPI record was last updated 12 years ago. St. Jude Medical Center & Aesthetic Care operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as St. Jude Medical Center & Aesthetic Care. The authorized official of this NPI record is Dr. Godwin Stanley Okoye Md (Medical Director)
- NPI
- 1518260090
- Provider Legal Name
- ST. JUDE MEDICAL & AESTHETIC CARE CENTER, LLC
- Other Organization Name
- ST. JUDE MEDICAL CENTER & AESTHETIC CARE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 131 N MOON AVE SUITES 3 & 4 BRANDON, FL 33510
- Location Phone
- (813) 315-9898
- Location Fax
- (813) 438-5967
- Mailing Address
- 4810 PORTOBELLO CIR VALRICO, FL 33596
- Mailing Phone
- (813) 315-9898
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-06-2010
- Last Update Date
- 10-08-2013
- Code Navigator
Ophthalmologists like St. Jude Medical Center & Aesthetic Care specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME107980
- License State
- FL
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 132700000X | Dietary & Nutritional Service Providers | Dietary Manager | |
| 2 | 146D00000X | Emergency Medical Service Providers | Personal Emergency Response Attendant | ME107980 (FL) |
| 3 | 207QA0401X | Allopathic & Osteopathic Physicians | Family Medicine | ME107980 (FL) |
| 4 | 2083P0901X | Allopathic & Osteopathic Physicians | Preventive Medicine | |
| 5 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | ME107980 (FL) |
| 6 | 208U00000X | Allopathic & Osteopathic Physicians | Clinical Pharmacology | ME107980 (FL) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2025474
- Facility Type
- Physician Office
- Certificate Effective Date
- January 07, 2024
- Certificate Expiration Date
- January 06, 2026
- Laboratory Director
- DR. IFEOMA F. OKOYE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to St. Jude Medical Center & Aesthetic Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 1 | 8 | 2 | 6 | 0 | 0 | 9 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 2 | 8 | 4 | 6 | 0 | 0 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 2 + 8 + 4 + 6 + 0 + 0 + 1 + 8 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1518260090 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1386824209 | BERNARD GOLDSTEIN PA Organization | Podiatrist (Foot & Ankle Surgery) | 131 N MOON AVE SUITE 6 BRANDON, FL 33510 (813) 972-3338 |
| 1326304163 | TODD L HOLM LMT Individual | Massage Therapist | 131 N MOON AVE SUITE 2 BRANDON, FL 33510 (813) 681-7868 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1518260090, enumerated in the NPI registry as an "organization" on December 06, 2010
The provider is located at 131 N Moon Ave Suites 3 & 4 Brandon, Fl 33510 and the phone number is (813) 315-9898
This medical organization specializes in Ophthalmology with taxonomy code 207W00000X
The provider's CLIA number is 10D2025474 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on December 06, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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