Individual provider Active NPI

Maggie Yamin, O.D.

  • Optometrist
  • Hollywood, FL
National Provider Identifier
1023781747
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6042 Issued in FL
Practice address
4330 Sheridan St Ste 102B
Hollywood, FL 33021-1407
Phone
(754) 231-1632
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6042 FL Primary

Addresses

Primary practice location

4330 Sheridan St Ste 102B
Hollywood, FL 33021-1407

Mailing address

24918 Bella Vista Dr
Calabasas, CA 91302-3035
Phone (818) 264-8346

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
I20211015002460 FL Practitioner - Optometry 3577961879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc. Optometrist CurrentSince Jul 15, 2021 Accepting new patients
Nova Southeastern University Inc. CurrentSince Jul 15, 2021 Accepting new patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University, Inc Past Accepting new patients

Locations

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1111 W Broward Blvd
Ft Lauderdale, FL 33312
Phone (954) 463-7313

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 4

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1023781747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24918 BELLA VISTA DR",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023035",
            "telephone_number": "818-264-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 SHERIDAN ST STE 102B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211407",
            "telephone_number": "754-231-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMIN",
        "first_name": "MAGGIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.