JACOB MITTELSTAEDT OD
NPI 1861062176
Optometrist in Haines City, FL

Q: What is Jacob Mittelstaedt's NPI number?

The NPI number for Jacob Mittelstaedt is 1861062176. It was assigned to this individual provider in the NPPES registry on June 29, 2021.

Q: What is Jacob Mittelstaedt's specialty?

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

Active since June 29, 2021PECOS EnrolledAccepts Medicare Assignment

119 PATTERSON RD, HAINES CITY, FL 33844(863) 421-2700(863) 421-7629 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 13, 2023, Dec 10, 2021, Jun 29, 2021 (3 updates tracked since 2021).

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About Jacob Mittelstaedt Od NPPES

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

JACOB MITTELSTAEDT OD (NPI 1861062176) is an individual optometrist in Haines City, Florida, licensed in Florida (OPC6190) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (2021).

NPPES Registry Identity

NPI1861062176

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameJACOB MITTELSTAEDTCredential: OD

Location Address119 PATTERSON RDHaines City, FL 33844-7803

Mailing Address8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442 · (703) 847-8899 · Fax (571) 223-6780

Phone(863) 421-2700

Fax(863) 421-7629

Sole ProprietorNo

Medical School CMSNew England College Of OptometryGraduated 2021

Enumeration DateJune 29, 2021

Last NPPES UpdateMarch 13, 20233 updates tracked since enumeration

NPPES CertifiedMarch 13, 2023

✔ NPI 1861062176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in FL · OPC6190✔ Licensed in CO · 0003685

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.

119 PATTERSON RD, Haines City, FL 33844

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Mittelstaedt Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527462696

PECOS Enrollment IDI20230324001286

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33844 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.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MYEYEDR. OPTOMETRY OF FLORIDA, LLC

Optometrist