Individual provider Active NPI

J. Louis Korman, O.D.

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1265627814
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2537 Issued in FL
Practice address
12055 Pines Blvd
Pembroke Pines, FL 33026-4112
Phone
(954) 392-5450
Fax
(954) 431-0745
NPI assigned
Sep 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2537 FL Primary

Addresses

Primary practice location

12055 Pines Blvd
Pembroke Pines, FL 33026-4112

Mailing address

11891 Royal Palm Blvd
Apt. 203
Coral Springs, FL 33065-7374
Phone (954) 344-8127

Other identifiers 1

IdentifierTypeStateIssuer
939468OtherFLEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130802000727 NY Practitioner - Optometry 1153562145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 N Galleria Dr
Suite 128
Middletown, NY 10941-3028
Phone (845) 692-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2537FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
V Z Optical Corp Optometrist CurrentSince Mar 9, 2013 Accepting new patients
Eye to Eye Vision Center Optometrist PastSince Mar 9, 2013 Accepting new patients

Locations

1101 Amboy Ave
Edison, NJ 08837
Phone (718) 477-6700

1 N Galleria Dr
Ste 128
Middletown, NY 10941
Phone (845) 692-2020

555 Route 211 E
Ste 3
Middletown, NY 10941
Phone (845) 692-2020

1911 Richmond Ave
Ste 210
Staten Island, NY 10314
Phone (718) 513-1412

Organizations & group practices 2

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1265627814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11891 ROYAL PALM BLVD",
            "address_2": "APT. 203",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330657374",
            "telephone_number": "954-344-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12055 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264112",
            "telephone_number": "954-392-5450",
            "fax_number": "954-431-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORMAN",
        "first_name": "J.",
        "middle_name": "LOUIS",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "939468",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.