Individual provider Active NPI

Stan S Choi, PA

  • Optometrist
  • Boynton Beach, FL
National Provider Identifier
1104131937
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4512 Issued in FL
Practice address
650 N Congress Ave
Boynton Beach, FL 33426-3445
Phone
(917) 561-9791
NPI assigned
Aug 17, 2010
Last updated
Oct 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4512 FL Primary

Addresses

Primary practice location

650 N Congress Ave
Boynton Beach, FL 33426-3445

Mailing address

18642 Cape Sable Dr
Boca Raton, FL 33498-6374
Phone (917) 561-9791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OPC4512FLMDOptometrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1104131937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18642 CAPE SABLE DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986374",
            "telephone_number": "917-561-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N CONGRESS AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263445",
            "telephone_number": "917-561-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "STAN",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-17",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.