NPIMap

Organization Active NPI

Steven Wigdor O.D. P.a.

  • Optometrist
  • Aventura, FL
National Provider Identifier
1255352258
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1791 Issued in FL
Legal business name
STEVEN WIGDOR O.D. P.A.
Practice address
17941 Biscayne Blvd
Aventura, FL 33160-2502
Phone
(305) 931-0225
Fax
(305) 931-0238
NPI assigned
Jul 22, 2006
Last updated
Jul 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Authorized official

Name
Dr. Steven Wigdor, O.D.NPI 1215929989
Title
Owner
Phone
(305) 931-0225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1791 FL Primary

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
078392701MedicaidFL
582102001OtherFLMEDICARE DME
Q0243OtherFLMEDICARE GROUP PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1255352258",
    "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": {
        "organization_name": "STEVEN WIGDOR O.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "WIGDOR",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-931-0225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078392701",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "582102001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "Q0243",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.