Individual provider Active NPI

Brice Alan Roselli, O.D.

  • Optometrist
  • Vero Beach, FL
National Provider Identifier
1194768135
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3612 Issued in FL
Practice address
333 17TH St
Suite G
Vero Beach, FL 32960-5670
Phone
(772) 978-0845
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3612 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OPC 3612 FL

Addresses

Primary practice location

333 17TH St
Suite G
Vero Beach, FL 32960-5670

Mailing address

333 17TH St
Suite G
Vero Beach, FL 32960-5670
Phone (772) 978-0845

Other identifiers 1

IdentifierTypeStateIssuer
20015AOtherFLBCBSOFFL PROVIDER #

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
I20091111000728 FL Practitioner - Optometry 7719025709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Treasure Coast Eye Associates PAGroup PAC ID 1052400231, 2 clinicians

Practice addresses (Care Compare)

333 17TH St
Suite G
Vero Beach, FL 32960-5672
Phone (772) 978-0845

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3612FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Eye Associates PA Optometrist CurrentSince Jan 15, 2003 Accepting new patients
Treasure Coast Eye Associates, PA Current Accepting new patients
Delrowe Eye Care, PA Past Accepting new patients

Locations

333 17th St
Ste G
Vero Beach, FL 32960
Phone (772) 569-2214

Organizations & group practices 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1194768135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 17TH ST",
            "address_2": "SUITE G",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605670",
            "telephone_number": "772-978-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 17TH ST",
            "address_2": "SUITE G",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605670",
            "telephone_number": "772-978-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELLI",
        "first_name": "BRICE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3612",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC 3612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSOFFL PROVIDER #",
            "identifier": "20015A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.