Organization Active NPI

Michael S Nason OD PA

  • Optometrist
  • Middleburg, FL
National Provider Identifier
1083887400
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC002692 Issued in FL
Legal business name
MICHAEL S NASON OD PA
Practice address
4415 Sidewinder TRL
Middleburg, FL 32068-3250
Phone
(561) 951-7285
NPI assigned
Apr 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Dr. Michael S. Nason, O.D.
Title
President
Phone
(561) 951-7285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC002692 FL Primary

Addresses

Primary practice location

4415 Sidewinder TRL
Middleburg, FL 32068-3250

Mailing address

4415 Sidewinder TRL
Middleburg, FL 32068-3250
Phone (561) 951-7285

Other identifiers 1

IdentifierTypeStateIssuer
620019200MedicaidFL

National Provider Directory

National Provider Directory

Locations

1900 Okeechobee Blvd
Ste C10
West Palm Beach, FL 33409
Phone (561) 471-0888

1937 N Military Trl
Ste A
West Palm Beach, FL 33409
Phone (561) 471-0888

1937 N Military Trl
Ste E
West Palm Beach, FL 33409

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1083887400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 SIDEWINDER TRL",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683250",
            "telephone_number": "561-951-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 SIDEWINDER TRL",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683250",
            "telephone_number": "561-951-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S NASON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "NASON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-951-7285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC002692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620019200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.