Individual provider Active NPI

Gabriela Isabel Olivares, O.D

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1336553429
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4946 Issued in FL
Practice address
1732 University Drive
Pembroke Pines, FL 33024
Phone
(954) 432-7711
Fax
(954) 432-8017
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4946 FL Primary

Addresses

Primary practice location

1732 University Drive
Pembroke Pines, FL 33024

Mailing address

1732 University Drive
Pembroke Pines, FL 33024
Phone (954) 432-7711

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
I20150324001937 FL Practitioner - Optometry 5294052619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert a. Davis O.D. P.a.Group PAC ID 4082644752, 5 clinicians

Practice addresses (Care Compare)

1732 N University Dr
Pembroke Pines, FL 33024-3602
Phone (954) 432-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4946FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert a. Davis OD PA Optometrist CurrentSince Apr 2, 2015 Accepting new patients
Eye Physicians of Florida LLP CurrentSince Apr 2, 2015 Accepting new patients

Locations

1732 N University Dr
Pembroke Pines, FL 33024
Phone (954) 432-7711

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1336553429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 UNIVERSITY DRIVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-432-7711",
            "fax_number": "954-432-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 UNIVERSITY DRIVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-432-7711",
            "fax_number": "954-432-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "GABRIELA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.