Individual provider Active NPI

Stephen Oppenheimer, OD, PA

  • Optometrist
  • Key West, FL
National Provider Identifier
1124211776
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC997 Issued in FL
Practice address
1708 N Roosevelt Blvd
Key West, FL 33040-7299
Phone
(305) 294-5503
Fax
(305) 294-5509
NPI assigned
Aug 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC997 FL Primary

Addresses

Primary practice location

1708 N Roosevelt Blvd
Key West, FL 33040-7299

Mailing address

1708 N Roosevelt Blvd
Key West, FL 33040-7299
Phone (305) 294-5503

Other identifiers 1

IdentifierTypeStateIssuer
84289300MedicaidFL

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
I20120113000342 FL Practitioner - Optometry 6709053879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oppenheimer Eye Clinic, PAGroup PAC ID 4082881149, 2 clinicians

Practice addresses (Care Compare)

1708 N Roosevelt Blvd
Key West, FL 33040-7299
Phone (305) 294-5503

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oppenheimer Eye Clinic, PA Optometrist CurrentSince Oct 18, 2000 Accepting new patients

Locations

3306 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 279-3400

1708 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 294-5503

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1124211776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 N ROOSEVELT BLVD",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330407299",
            "telephone_number": "305-294-5503",
            "fax_number": "305-294-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 N ROOSEVELT BLVD",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330407299",
            "telephone_number": "305-294-5503",
            "fax_number": "305-294-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPENHEIMER",
        "first_name": "STEPHEN",
        "credential": "OD, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84289300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

Verify at the official NPI Registry.