Individual provider Active NPI

Robert Ortiz, O.D.

  • Optometrist
  • South Miami, FL
National Provider Identifier
1154679694
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 004727 Issued in FL
Practice address
5858 SW 68TH St
South Miami, FL 33143-3693
Phone
(305) 661-8588
Fax
(305) 661-4906
NPI assigned
Aug 15, 2012
Last updated
Feb 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 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 OPC 004727 FL Primary

Addresses

Primary practice location

5858 SW 68TH St
South Miami, FL 33143-3693

Mailing address

5858 SW 68TH St
South Miami, FL 33143-3693
Phone (305) 661-8588

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
I20130411000399 FL Practitioner - Optometry 6800031683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A James Segal MD PA MedeyeassociatesGroup PAC ID 6901889542, 7 clinicians

Practice addresses (Care Compare)

5858 SW 68TH St
South Miami, FL 33143-3693
Phone (305) 661-8588

8250 NW 27TH St
Unit 311
Doral, FL 33122-1904
Phone (305) 661-8588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 004727FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
A James Segal MD PA Medeyeassociates CurrentSince Feb 1, 2015 Accepting new patients

Locations

8250 NW 27th St
Ste 311
Doral, FL 33122
Phone (305) 591-1085

9299 SW 152nd St
Ste 101
Palmetto Bay, FL 33157
Phone (305) 233-8043

5858 SW 68th St
South Miami, FL 33143

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, 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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1154679694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 SW 68TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433693",
            "telephone_number": "305-661-8588",
            "fax_number": "305-661-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 SW 68TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433693",
            "telephone_number": "305-661-8588",
            "fax_number": "305-661-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 004727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.