Individual provider Active NPI

Justin-Veni Galvez Echague, O.D.

  • Optometrist
  • Weston, FL
National Provider Identifier
1104072941
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002028 Issued in VA
Practice address
3961 Nighthawk Dr
Weston, FL 33331-4023
Phone
(954) 554-8860
NPI assigned
Aug 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT0003622 CO
Optometrist 152W00000X 3733-35 WI
Optometrist 152W00000X TPOP13 FL
Optometrist 152W00000X TA2960 MD
Optometrist 152W00000X 0618002028 VA Primary

Addresses

Primary practice location

3961 Nighthawk Dr
Weston, FL 33331-4023

Mailing address

8853 Woodgrove Ridge CT
Boynton Beach, FL 33473-4872
Phone (954) 554-8860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CO, MD, DC, NY, IA, MI7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20110615000531 VA Practitioner - Optometry 8224215454 Reassigns benefits to 2 organizations
I20220323002153 CO Practitioner - Optometry 8224215454 Reassigns benefits to 1 organization
I20240222001361 MD Practitioner - Optometry 8224215454 Reassigns benefits to 1 organization
I20240222001465 DC Practitioner - Optometry 8224215454 Reassigns benefits to 1 organization
I20240418001082 NY Practitioner - Optometry 8224215454 Reassigns benefits to 1 organization
I20240612003311 IA Practitioner - Optometry 8224215454 Reassigns benefits to 1 organization
I20240925002622 MI Practitioner - Optometry 8224215454 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009948NYMDPsychologist
OPT0003622COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Fort Dodge, Inc. CurrentSince Nov 26, 2024 Accepting new patients
Lynchburg Vision Associates PC Optometrist CurrentSince Jul 13, 2022 Accepting new patients
Abba Eye Care PC Optometrist CurrentSince Sep 1, 2024 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Mar 4, 2024 Accepting new patients
Eye Care Associates LLC Optometrist CurrentSince May 3, 2024 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Feb 9, 2024 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Feb 1, 2024 Accepting new patients
Myeyedr Optometry of Wisconsin, LLC Optometrist CurrentSince Mar 4, 2024 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Mar 4, 2024 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Mar 4, 2024 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Sep 17, 2024 Accepting new patients
Myeyedr Optometry of Wisconsin, LLC Optometrist CurrentSince Mar 4, 2024 Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Empire Vision Center, Inc CurrentSince Apr 4, 2024 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Sep 17, 2024 Accepting new patients
Visionworks, Inc Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Apr 4, 2024 Accepting new patients
Abba Eye Care PC Optometrist CurrentSince Sep 1, 2024 Accepting new patients
Community Health Center of Fort Dodge Inc. CurrentSince Nov 26, 2024 Accepting new patients
Myeyedr Optometry of Wisconsin, LLC Optometrist Current Accepting new patients
Sr Medical Associates LLC PastSince Feb 10, 2021 Accepting new patients

Locations (25 of 29)

1130 Lake Plaza Dr
Ste 130
Colorado Springs, CO 80906
Phone (719) 578-2020

1650 W US Highway 50
Pueblo, CO 81008
Phone (719) 542-1222

303 N Main St
Clarion, IA 50525
Phone (515) 532-3343

24 S Main St
Dayton, IA 50530
Phone (515) 547-2974

126 N 10th St
Fort Dodge, IA 50501
Phone (515) 576-6500

404 N Federal Ave
Mason City, IA 50401
Phone (641) 450-0601

1313 2nd St
Perry, IA 50220
Phone (515) 465-4203

223 W 7th St
Spencer, IA 51301
Phone (515) 576-6500

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

6804 Race Track Rd
Bowie, MD 20715
Phone (301) 262-1210

15431 Emerald Way
Bowie, MD 20716
Phone (301) 805-6132

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890

3620 28th St SE
Kentwood, MI 49512
Phone (616) 512-0323

48873 Hayes Rd
Shelby Township, MI 48315
Phone (586) 247-2121

23360 Eureka Rd
Taylor, MI 48180
Phone (734) 287-0024

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

3900 Wards Rd
Lynchburg, VA 24502
Phone (434) 832-0208

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1104072941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8853 WOODGROVE RIDGE CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334734872",
            "telephone_number": "954-554-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 NIGHTHAWK DR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333314023",
            "telephone_number": "954-554-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHAGUE",
        "first_name": "JUSTIN-VENI",
        "middle_name": "GALVEZ",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT0003622",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3733-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "TPOP13",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2960",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.