Individual provider Active NPI

Clayton Pawlak, OD

  • Optometrist
  • Pompano Beach, FL
National Provider Identifier
1346895422
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5730 Issued in FL
Practice address
2471 N Federal Hwy
Pompano Beach, FL 33064-6853
Phone
(954) 943-3606
Fax
(954) 943-3569
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 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 OPC5730 FL Primary

Addresses

Primary practice location

2471 N Federal Hwy
Pompano Beach, FL 33064-6853

Mailing address

2471 N Federal Hwy
Pompano Beach, FL 33064-6853
Phone (954) 943-3606

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
I20190917002786 FL Practitioner - Optometry 7618206608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2471 N Federal Hwy
Pawlak Eye Care
Pompano Beach, FL 33064-6853
Phone (954) 943-3606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC5730FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clayton Pawlak OD, PLLC Optometrist CurrentSince Nov 1, 2019 Accepting new patients

Locations

2471 N Federal Hwy
Pompano Beach, FL 33064
Phone (954) 943-3606

Networks

  • Freedom Health HMO Network

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1346895422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 N FEDERAL HWY",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330646853",
            "telephone_number": "954-943-3606",
            "fax_number": "954-943-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 N FEDERAL HWY",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330646853",
            "telephone_number": "954-943-3606",
            "fax_number": "954-943-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLAK",
        "first_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.