Jennifer Ann Pathiyil, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5424 Issued in FL

Practice address

11645 Biscayne Blvd Ste 103
North Miami, FL 33181-3138

Phone

(305) 538-8835

Fax

(305) 994-0054

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Miami Beach Community Health Center, Inc.Group PAC ID 8123090925, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Miami Beach Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Miami Beach, FL
  • NPI 1063411874
  Medicare reassignment Care Compare group NPD
• Miami Beach Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1053780734
  NPD
• Miami Beach Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1467606681
  NPD

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1124545827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 103",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331395504",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 71st St",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331413647",
            "country_code": "US",
            "telephone_number": "305-538-8835",
            "fax_number": "305-994-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHIYIL",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101304000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Partners of Internal Medicine PA
• Lisamary Pastor
• Rita Patel, DMD
• Path Medical Center Inc
• Path Medical, LLC
• Grace Wai Mun Pau, A.P.
• Paula E Hutchinson DDS
• Paulo Lazaro LCSW LLC
• Pavel I Ivanov DMD Ms PA
• McKenzi A Payne, PA-C

• Optometrist in North Miami, FL
• Providers in North Miami, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.