Individual provider Active NPI

Lionel D Richards Jr., O.D.

  • Optometrist
  • Boynton Beach, FL
National Provider Identifier
1275668519
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1247 Issued in FL
Practice address
2300 S Congress Ave Ste 102
Boynton Beach, FL 33426-7400
Phone
(561) 742-1944
Fax
(561) 742-0525
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 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 OPC1247 FL Primary

Addresses

Primary practice location

2300 S Congress Ave Ste 102
Boynton Beach, FL 33426-7400

Mailing address

2300 S Congress Ave Ste 102
Boynton Beach, FL 33426-7400
Phone (561) 742-1944

Other identifiers 1

IdentifierTypeStateIssuer
084843300MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050214000270 FL Practitioner - Optometry 7012969553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
L David Richards Jr Optometric Physician Optometrist CurrentSince Oct 6, 2013 Accepting new patients

Locations

2300 S Congress Ave
Ste 102
Boynton Beach, FL 33426
Phone (561) 742-1944

Organizations & group practices 1

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1275668519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S CONGRESS AVE STE 102",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267400",
            "telephone_number": "561-742-1944",
            "fax_number": "561-742-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S CONGRESS AVE STE 102",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267400",
            "telephone_number": "561-742-1944",
            "fax_number": "561-742-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "LIONEL",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084843300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.