Individual provider Active NPI

Steven Wigdor, O.D.

  • Optometrist
  • Aventura, FL
National Provider Identifier
1215929989
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC001791 Issued in FL
Practice address
17941 Biscayne Blvd
Aventura, FL 33160-2502
Phone
(305) 931-0225
Fax
(305) 931-0238
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 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 OPC001791 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OPC001791 FL

Addresses

Primary practice location

17941 Biscayne Blvd
Aventura, FL 33160-2502

Mailing address

17941 Biscayne Blvd
Aventura, FL 33160-2502
Phone (305) 931-0225

Other identifiers 3

IdentifierTypeStateIssuer
078392700MedicaidFL
5821020002OtherFLMEDICARE DME SUPPLIER
5821020001OtherFLMEDICARE DME SUPPLIER

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
I20060921000344 FL Practitioner - Optometry 4183629371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17941 Biscayne Blvd
Aventura, FL 33160-2502

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC001791FLMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosin Eyecare, P.a. Optometrist CurrentSince Aug 1, 2019 Accepting new patients
Rosin Eyecare, P.a. Optometrist CurrentSince Aug 1, 2019 Accepting new patients
Dr. Steven E. Wigdor, PA Past Accepting new patients

Locations

17941 Biscayne Blvd
Aventura, FL 33160
Phone (305) 931-0225

1825 NE 164th St
North Miami Beach, FL 33162
Phone (305) 945-7113

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1215929989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17941 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602502",
            "telephone_number": "305-931-0225",
            "fax_number": "305-931-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17941 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602502",
            "telephone_number": "305-931-0225",
            "fax_number": "305-931-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGDOR",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001791",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC001791",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078392700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME SUPPLIER",
            "identifier": "5821020002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME SUPPLIER",
            "identifier": "5821020001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.