Active NPI
Jessica Champagnie, OD
- Optometrist
- Deerfield Beach, FL
National Provider Identifier
1154008076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC006268
- Practice address
- 3890 NW 2ND Ave
Deerfield Beach, FL 33064-2701 - Phone
- (954) 328-0823
- NPI assigned
- Jul 3, 2023
- Last updated
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC006268 | FL | Primary |
Addresses
Primary practice location
3890 NW 2ND Ave
Deerfield Beach, FL 33064-2701
Mailing address
3890 NW 2ND Ave
Deerfield Beach, FL 33064-2701
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC006268 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Cukierman & Gomez, Inc | Optometrist | Current | Accepting new patients |
| DRS. Cukierman & Gomez, Inc | Optometrist | Current | Accepting new patients |
| DRS. Cukierman & Gomez, Inc | Optometrist | Current | Accepting new patients |
Locations
3682 W Oakland Park Blvd
Lauderdale Lakes, FL 33311
Phone (954) 730-8087
246 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 442-4602
Networks
- Freedom Health HMO Network
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1154008076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3890 NW 2ND AVE",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "330642701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3890 NW 2ND AVE",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "330642701",
"telephone_number": "954-328-0823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNIE",
"first_name": "JESSICA",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC006268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.