Organization Active NPI

Craig T. Hanley, O.D., P.a.

  • Optometrist
  • Vero Beach, FL
National Provider Identifier
1013206580
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC-1651 Issued in FL
Legal business name
CRAIG T. HANLEY, O.D., P.A.
Practice address
715 17 St.
Vero Beach, FL 32960
Phone
(772) 933-6000
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Craig T. Hanley, O.D.NPI 1871510511
Title
President
Phone
(954) 691-7160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC-1651 FL Primary

Addresses

Primary practice location

715 17 St.
Vero Beach, FL 32960

Mailing address

656 S. Easy Street
Sebastian, FL 32958
Phone (954) 691-7160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110303000328 FL Part B Supplier - Clinic/Group Practice 3577745116 Receives reassigned benefits from 1 practitioner
Practice locations: Vero Beach, FL

National Provider Directory

National Provider Directory

Locations

715 17th St
Vero Beach, FL 32960
Phone (772) 569-4822

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1013206580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 S. EASY STREET",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "32958",
            "telephone_number": "954-691-7160",
            "fax_number": "954-763-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 17 ST.",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "telephone_number": "772-933-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG T. HANLEY, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "HANLEY",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-691-7160",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC-1651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.