NPIMap

Organization Active NPI

Brevard Eye Center

  • Eyewear Supplier
  • Merritt Island, FL
National Provider Identifier
1194940569
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
BREVARD EYE CENTER
Practice address
250 N Courtenay Pkwy
Merritt Island, FL 32953-3495
Phone
(321) 453-5700
Fax
(321) 453-5370
NPI assigned
Apr 13, 2007
Organization subpart
Yes
Parent organization
BREVARD EYE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Mr. Gary R Hardey
Title
Ceo
Phone
(321) 984-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

250 N Courtenay Pkwy
Merritt Island, FL 32953-3495

Mailing address

665 S Apollo Blvd
Melbourne, FL 32901-1485
Phone (321) 984-3200

Other identifiers 8

IdentifierTypeStateIssuer
1003075730OtherNPI DELATORRE
1750322871OtherNPI HENDRIX
086944906MedicaidFL
1558456689OtherNPI GROUP
252338802MedicaidFL
0539980003OtherDEMERC NC
1518908607OtherNPI EHRET
1477503696OtherNPI TRES

Other names 1

  • Paul J Befanis MD PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000642 FL Part B Supplier - Clinic/Group Practice 7719884576 Receives reassigned benefits from 8 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Melbourne, FL; Merritt Island, FL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Paul J Befanis MD PA

Locations

100 N Orlando Ave
Cocoa Beach, FL 32931
Phone (321) 613-4569

7775 N Wickham Rd
Melbourne, FL 32940
Phone (321) 984-3200

250 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 453-5700

14120 US Highway 1
Sebastian, FL 32958
Phone (407) 581-1300

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1194940569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 S APOLLO BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011485",
            "telephone_number": "321-984-3200",
            "fax_number": "321-984-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533495",
            "telephone_number": "321-453-5700",
            "fax_number": "321-453-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD EYE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREVARD EYE CENTER",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "HARDEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-984-3200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI DELATORRE",
            "identifier": "1003075730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI HENDRIX",
            "identifier": "1750322871",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086944906",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1558456689",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252338802",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEMERC NC",
            "identifier": "0539980003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI EHRET",
            "identifier": "1518908607",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TRES",
            "identifier": "1477503696",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paul J Befanis MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.