Individual provider Active NPI

Laura L Martinez, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1265868608
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4839 Issued in FL
Practice address
3200 S University Dr
Terry BLDG. Suite 1402
Davie, FL 33328-2018
Phone
(954) 262-4200
Fax
(954) 262-3217
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4839 FL Primary

Addresses

Primary practice location

3200 S University Dr
Terry BLDG. Suite 1402
Davie, FL 33328-2018

Mailing address

3200 S University Dr
Terry BLDG. Suite 1402
Davie, FL 33328-2018
Phone (954) 262-1402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211230001668 DE Practitioner - Optometry 9931335056
I20221029000304 IL Practitioner - Optometry 9931335056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
OPC4839FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Oct 30, 2022 Accepting new patients
Nova Southeastern University, Inc Past Accepting new patients

Locations

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

19100 Ridgewood Pkwy
Bldg 1
San Antonio, TX 78259
Phone (726) 444-4069

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1265868608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "TERRY BLDG. SUITE 1402",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1402",
            "fax_number": "954-262-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "TERRY BLDG. SUITE 1402",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4200",
            "fax_number": "954-262-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.