NPIMap

Organization Active NPI

Mobile Vision Doctors LLC

  • Low Vision Rehabilitation Optometrist
  • Hollywood, FL
National Provider Identifier
1356697064
Registry record updated Feb 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
OPC3957 Issued in FL
Legal business name
MOBILE VISION DOCTORS LLC
Practice address
1315 Silk Oak Dr
Hollywood, FL 33021-1367
Phone
(305) 439-2015
Fax
(305) 503-9250
NPI assigned
Jul 31, 2012
Last updated
Feb 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2023

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

Authorized official

Name
Dr. Ryan Carlo Verxagio, O.D.NPI 1669432969
Title
Owner/Manager
Phone
(305) 439-2015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WL0500X OPC3957 FL Primary

Addresses

Primary practice location

1315 Silk Oak Dr
Hollywood, FL 33021-1367

Mailing address

1315 Silk Oak Dr
Hollywood, FL 33021-1367
Phone (305) 439-2015

Other identifiers 9

IdentifierTypeStateIssuer
1194014845OtherFLNPI OF ONE OF THE PROVIDERS OF THE GROUP
1851648026OtherFLNPI OF THE SAME BUSINESS BUT IN ANOTHER COUNTY (DADE)
024018600MedicaidFL
1124642269OtherFLNPI OF ONE OF THE PROVIDERS OF THE GROUP
1528342631OtherFLNPI OF ONE OF THE PROVIDERS OF THE GROUP
1669432969OtherFLNPI OF ONE OF THE PROVIDERS OF THE GROUP
1700520608OtherFLNPI OF ONE OF THE PROVIDERS OF THE GROUP
1851648026OtherFLNPI (SAME COMPANY, DIFFERENT COUNTY) DADE, FLORIDA
1831682178OtherFLNPI OF ONE OF THE PROVIDERS OF THE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120925000327 FL Part B Supplier - Clinic/Group Practice 4385893973 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mobile Vision Doctors LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677369600000",
    "number": "1356697064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 SILK OAK DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211367",
            "telephone_number": "305-439-2015",
            "fax_number": "305-503-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 SILK OAK DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211367",
            "telephone_number": "305-439-2015",
            "fax_number": "305-503-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE VISION DOCTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "VERXAGIO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "CARLO",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "305-439-2015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC3957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF ONE OF THE PROVIDERS OF THE GROUP",
            "identifier": "1194014845",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF THE SAME BUSINESS BUT IN ANOTHER COUNTY (DADE)",
            "identifier": "1851648026",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024018600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF ONE OF THE PROVIDERS OF THE GROUP",
            "identifier": "1124642269",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF ONE OF THE PROVIDERS OF THE GROUP",
            "identifier": "1528342631",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF ONE OF THE PROVIDERS OF THE GROUP",
            "identifier": "1669432969",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF ONE OF THE PROVIDERS OF THE GROUP",
            "identifier": "1700520608",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (SAME COMPANY, DIFFERENT COUNTY) DADE, FLORIDA",
            "identifier": "1851648026",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF ONE OF THE PROVIDERS OF THE GROUP",
            "identifier": "1831682178",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.