Individual provider Active NPI

Patrick Joseph Cassidy

  • Optometrist
  • Pompano Beach, FL
National Provider Identifier
1134612948
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5019 Issued in FL
Practice address
5 W Sample Rd
Pompano Beach, FL 33064-3542
Phone
(954) 782-1700
NPI assigned
Jun 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5019 FL Primary

Addresses

Primary practice location

5 W Sample Rd
Pompano Beach, FL 33064-3542

Mailing address

5 W Sample Rd
Pompano Beach, FL 33064-3542
Phone (954) 782-1700

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
I20190125000041 FL Practitioner - Optometry 9931446184 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5019FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
William J Rand Mdpa CurrentSince Jul 31, 2018 Accepting new patients

Locations

5 W Sample Rd
Deerfield Beach, FL 33064
Phone (954) 782-1700

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": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1134612948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W SAMPLE RD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330643542",
            "telephone_number": "954-782-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W SAMPLE RD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330643542",
            "telephone_number": "954-782-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "PATRICK",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.