Individual provider Active NPI

Megan Nicole Demartino, OD

  • Optometrist
  • Hollywood, FL
National Provider Identifier
1346864964
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5813 Issued in FL
Practice address
1050 N Federal Hwy
Hollywood, FL 33020-3540
Phone
(954) 458-2112
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5813 FL Primary

Addresses

Primary practice location

1050 N Federal Hwy
Hollywood, FL 33020-3540

Mailing address

2681 Brook Valley Rd
Frederick, MD 21701-6801
Phone (814) 444-2897

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
I20210223000422 FL Practitioner - Optometry 1557776689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5813FLMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley D Braverman MD LLC Optometrist CurrentSince Nov 22, 2020 Accepting new patients

Locations

1050 N Federal Hwy
Hollywood, FL 33020
Phone (954) 458-2112

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1346864964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2681 BROOK VALLEY RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016801",
            "telephone_number": "814-444-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N FEDERAL HWY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203540",
            "telephone_number": "954-458-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARTINO",
        "first_name": "MEGAN",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.