Individual provider Active NPI

Nicholaos G Rokanas, O.D.

  • Optometrist
  • Delray Beach, FL
National Provider Identifier
1104969161
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3163 Issued in FL
Practice address
1715 S Federal Hwy
Delray Beach, FL 33483-3329
Phone
(561) 276-5099
Fax
(561) 274-9697
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3163 FL Primary
Optometrist 152W00000X TUV007654 NY

Addresses

Primary practice location

1715 S Federal Hwy
Delray Beach, FL 33483-3329

Mailing address

1715 S Federal Hwy
Delray Beach, FL 33483-3329
Phone (561) 276-5099

Other identifiers 2

IdentifierTypeStateIssuer
04057645MedicaidNY
92040288561MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151007000346 NY Practitioner - Optometry 8729073408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3163FLMDOptometrist
TUV007654NYMDOptometrist
007654NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision Center P.a. Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1104969161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 S FEDERAL HWY",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334833329",
            "telephone_number": "561-276-5099",
            "fax_number": "561-274-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 S FEDERAL HWY",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334833329",
            "telephone_number": "561-276-5099",
            "fax_number": "561-274-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROKANAS",
        "first_name": "NICHOLAOS",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3163",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04057645",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92040288561",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.