Organization Active NPI

Michael Loeffler MD PA

  • Ophthalmology Physician
  • Lighthouse Point, FL
National Provider Identifier
1245355619
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
FLME0057699 Issued in FL
Legal business name
MICHAEL LOEFFLER MD PA
Practice address
2100 NE 36TH St Ste 102
Lighthouse Point, FL 33064-7574
Phone
(954) 786-5353
Fax
(954) 786-5340
NPI assigned
Mar 21, 2007
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Patricia Ricardez
Title
Manager
Phone
(954) 786-5353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X FLME0057699 FL Primary

Addresses

Primary practice location

2100 NE 36TH St Ste 102
Lighthouse Point, FL 33064-7574

Mailing address

2100 NE 36TH St Ste 102
Lighthouse Point, FL 33064-7574
Phone (954) 786-5353

Other identifiers 2

IdentifierTypeStateIssuer
11869100MedicaidFL
DG7554OtherFLRAILROAD MEDICARE

Other names 1

  • Center for Ophthalmology & Laser Surgery Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121008000287 FL Part B Supplier - Clinic/Group Practice 9638299027 Receives reassigned benefits from 3 practitioners
Practice locations: Lighthouse Point, FL

National Provider Directory

National Provider Directory

Locations

2100 NE 36th St
Ste 102
Lighthouse Point, FL 33064
Phone (954) 786-5353

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1245355619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE 36TH ST STE 102",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647574",
            "telephone_number": "954-786-5353",
            "fax_number": "954-786-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE 36TH ST STE 102",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647574",
            "telephone_number": "954-786-5353",
            "fax_number": "954-786-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL LOEFFLER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "RICARDEZ",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-786-5353"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "FLME0057699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11869100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG7554",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Ophthalmology & Laser Surgery",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Center for Ophthalmology & Laser Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lighthouse Point, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.