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DR. THEODORE M BRINK OD
NPI 1174616155
Optometrist in Jacksonville, FL

Active since October 02, 2006PECOS Enrolled
11406-1 SAN JOSE BLVD, JACKSONVILLE, FL 32223(904) 260-3839(904) 260-7879 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Theodore M Brink Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE M BRINK OD (NPI 1174616155) is an individual optometrist in Jacksonville, Florida, licensed in Florida (OFC2491) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174616155
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. THEODORE M BRINKCredential: OD
Location Address11406-1 SAN JOSE BLVDJacksonville, FL 32223
Mailing Address11406-1 San Jose BlvdJacksonville, FL 32223 · (904) 260-3839 · Fax (904) 260-7879
Phone(904) 260-3839
Fax(904) 260-7879
Sole ProprietorNo
Enumeration DateOctober 2, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174616155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in FL · OFC2491
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
11406-1 SAN JOSE BLVD, Jacksonville, FL 32223
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Other Identifiers 2

Medicare ID-Type Unspecified910245Eyemed
Medicare UPINU48141

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Theodore M Brink Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Theodore Brink reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fleming Island Vision Center, Inc.
1,598 mi
Optometrist
1524 COUNTY ROAD 220 STE 5
Fleming Island, FL 32003
  • Reassigned Medicare billing, Florida enrollment
  • 10 clinicians in this Medicare group
NPI 1245482710 (904) 637-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Brink's NPI number?

The NPI number for Theodore Brink is 1174616155. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Theodore Brink located?

Theodore Brink practices at 11406-1 San Jose Blvd, Jacksonville, FL 32223. The listed phone number is (904) 260-3839.

What is Theodore Brink's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Theodore Brink enrolled in Medicare?

Yes. Theodore Brink is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Theodore Brink's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Brink reassigns Medicare benefits to Fleming Island Vision Center, Inc. (Fleming Island, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theodore Brink's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theodore Brink accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Oscar Health and 8 other insurers list Theodore Brink as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Theodore Brink was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.