Active NPI
Matthew J. Fensin, O.D.
- Optometrist
- Miami, FL
National Provider Identifier
1255460929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC1148
- Practice address
- 13767 SW 152ND St
Miami, FL 33177-8126 - Phone
- (305) 255-8822
- Fax
- (305) 255-9507
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC1148 | FL | Primary |
Addresses
Primary practice location
13767 SW 152ND St
Miami, FL 33177-8126
Mailing address
13767 SW 152ND St
Miami, FL 33177-8126
Phone (305) 255-8822
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131122001414 | FL | Practitioner - Optometry | 6204062144 | Practice locations: Miami, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1255460929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13767 SW 152ND ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331778126",
"telephone_number": "305-255-8822",
"fax_number": "305-255-9507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13767 SW 152ND ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331778126",
"telephone_number": "305-255-8822",
"fax_number": "305-255-9507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENSIN",
"first_name": "MATTHEW",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC1148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.