Michael Broder, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2949 Issued in FL

Practice address

2165 Tamiami TRL S
Venice, FL 34293-5034

Phone

(941) 493-8878

Fax

(941) 408-8446

NPI assigned

Nov 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ocular Services Inc.

  • Durable Medical Equipment & Medical Supplies
  • Venice, FL
  • NPI 1912176371
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1225104136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935034",
            "telephone_number": "941-493-8878",
            "fax_number": "941-408-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935034",
            "telephone_number": "941-493-8878",
            "fax_number": "941-408-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridge Care LLC
• Brian T Briggs, MD
• Kimberly Louise Brimlow, COTA/L
• Lauren Mikel Broadway, M.D.
• Alexander Moore Brocato, OD
• Kelly C Brothers, DPT
• Cassandra Davis Brower
• Richard Allen Brown, RPH
• Robin Carmencita Brown, OTR/L
• Broy Enterprises Inc.

• Optometrist in Venice, FL
• Providers in Venice, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.

Verify at the official NPI Registry.