Individual provider Active NPI

Frank Tomas Wenzel, OD

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1104811736
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC002315 Issued in FL
Practice address
1770 NW 122ND Ter
Pembroke Pines, FL 33026-1967
Phone
(954) 433-1490
Fax
(954) 433-0994
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC002315 FL Primary

Addresses

Primary practice location

1770 NW 122ND Ter
Pembroke Pines, FL 33026-1967

Mailing address

1770 NW 122ND Ter
Pembroke Pines, FL 33026-1967
Phone (954) 433-1490

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
I20160309000096 FL Practitioner - Optometry 1153444245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

4455 Cleveland Ave
Suite a
Fort Myers, FL 33901-9057
Phone (239) 939-5393

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2315FLMDMental Health Counselor
OPC002315FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors Optical Outlets PA Optometrist Current Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Feb 7, 2020 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Feb 7, 2020 Accepting new patients
Flamingo Falls Eye Care Optometrist PastSince Aug 4, 2000 Accepting new patients
Jaime a. Balaguer, Jr., O.D., PA Optometrist Past Accepting new patients

Locations

4455 Cleveland Ave
Ste A
Fort Myers, FL 33901
Phone (239) 939-5393

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1104811736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 NW 122ND TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261967",
            "telephone_number": "954-433-1490",
            "fax_number": "954-433-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 NW 122ND TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261967",
            "telephone_number": "954-433-1490",
            "fax_number": "954-433-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "FRANK",
        "middle_name": "TOMAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC002315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.