EAST LAKE EYECARE & EYEWEAR INC – Optometrist, NPI 1578633442

EAST LAKE EYECARE & EYEWEAR INC is a healthcare provider. based in Palm harbor, Florida. specializing in Optometrist. The organization holds a License No. 3810 (FL). The NPI Number for EAST LAKE EYECARE & EYEWEAR INC is 1578633442

Main info

Organization
Name
EAST LAKE EYECARE & EYEWEAR INC
NPI
1578633442
Phone
(727) 781-7922
Address
3434 E LAKE RD STE 3
Authorized Official
DR. TARA M RUSOFF PRESIDENT O.D.
Enumeration Date
8 November 2006
Last Update Date
20 September 2014
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for EAST LAKE EYECARE & EYEWEAR INC

  • 3434 E LAKE RD STE 3

    PALM HARBOR, FL 346852401

    Phone: (727) 781-7922

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-07-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-07-31 (313 days ago).

Enrollment records

1

Earliest due date

2025-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20070724000173OClinic/Group PracticeFL2025-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34685)

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Reviews

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Frequently asked questions

Is there an official ID for EAST LAKE EYECARE & EYEWEAR INC in U.S. healthcare records?
The official identifier for EAST LAKE EYECARE & EYEWEAR INC is NPI 1578633442.
Is there an active status for EAST LAKE EYECARE & EYEWEAR INC?
For scheduling context, EAST LAKE EYECARE & EYEWEAR INC is shown as active in the registry.
How would a patient describe EAST LAKE EYECARE & EYEWEAR INC's focus?
For EAST LAKE EYECARE & EYEWEAR INC, the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is EAST LAKE EYECARE & EYEWEAR INC located near Palm Harbor?
EAST LAKE EYECARE & EYEWEAR INC currently maps to Palm Harbor, Florida in this extract.
When was this NPI issued?
Enumeration for EAST LAKE EYECARE & EYEWEAR INC is noted as November 8, 2006 where the registry provides it.

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