Individual provider Active NPI

Jaime Alejandro Balaguer Jr., O.D.

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1144342189
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3869 Issued in FL
Practice address
1770 NW 122ND Ter
Pembroke Pines, FL 33026-1967
Phone
(954) 433-1490
Fax
(954) 433-0994
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3869 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

Other identifiers 1

IdentifierTypeStateIssuer
621290500MedicaidFL

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
I20120501000418 FL Practitioner - Optometry 9032371414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3869FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaime a. Balaguer, Jr., O.D., PA Optometrist CurrentSince Dec 21, 2011 Accepting new patients
Flamingo Falls Eye Care Optometrist PastSince Aug 3, 2010 Accepting new patients

Locations

1770 NW 122nd Ter
Pembroke Pines, FL 33026
Phone (954) 431-1818

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1144342189",
    "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": "BALAGUER",
        "first_name": "JAIME",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621290500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.