Individual provider Active NPI

Massimo R Gramanzini, O.D.

  • Optometrist
  • Plantation, FL
National Provider Identifier
1003968751
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FL3116 Issued in FL
Practice address
12220 W Sunrise Blvd
Plantation, FL 33323-2233
Phone
(954) 423-8444
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X FL3116 FL Primary
Corneal and Contact Management Optometrist 152WC0802X FL3116 FL

Addresses

Primary practice location

12220 W Sunrise Blvd
Plantation, FL 33323-2233

Mailing address

12220 W Sunrise Blvd
Plantation, FL 33323-2233
Phone (954) 423-8444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130415000438 FL Practitioner - Optometry 3577709633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12220 W Sunrise Blvd
Plantation, FL 33323-2233

9090 W State Rd
84 Suite 101
Davie, FL 33324-4436
Phone (954) 423-8444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL3116FLMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Center, Inc. Optometrist CurrentSince Jan 13, 2013 Accepting new patients

Locations

12220 W Sunrise Blvd
Plantation, FL 33323
Phone (954) 261-9810

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1003968751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12220 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232233",
            "telephone_number": "954-423-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12220 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232233",
            "telephone_number": "954-423-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMANZINI",
        "first_name": "MASSIMO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL3116",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "FL3116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.