Individual provider Active NPI

Ariel Medina, O.D.

  • Optometrist
  • Pinecrest, FL
National Provider Identifier
1316056336
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4155 Issued in FL
Practice address
8247 SW 124TH St
Pinecrest, FL 33156-5900
Phone
(305) 233-1330
NPI assigned
Aug 30, 2006
Last updated
Dec 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4155 FL Primary

Addresses

Primary practice location

8247 SW 124TH St
Pinecrest, FL 33156-5900

Mailing address

8247 SW 124TH St
Pinecrest, FL 33156-5900
Phone (305) 233-1330

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
I20130416000061 FL Practitioner - Optometry 1557507621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8247 SW 124TH St
Pinecrest, FL 33156-5900
Phone (305) 233-1330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4155FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Medina's Optical, LLC. CurrentSince Feb 26, 2013 Accepting new patients

Locations

8247 SW 124th St
Pinecrest, FL 33156
Phone (305) 233-1330

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1316056336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8247 SW 124TH ST",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331565900",
            "telephone_number": "305-233-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8247 SW 124TH ST",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331565900",
            "telephone_number": "305-233-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinecrest, FL

Sources for this page

Verify at the official NPI Registry.