Organization Active NPI

Eyecare in Brevard Inc

  • Optometrist
  • Melbourne, FL
National Provider Identifier
1376085308
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 2792 Issued in FL
Legal business name
EYECARE IN BREVARD INC
Practice address
3200 N Wickham Rd
Ste 1
Melbourne, FL 32935-2321
Phone
(321) 253-3550
Fax
(321) 253-3591
NPI assigned
Nov 8, 2016
Last updated
Feb 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Authorized official

Name
Dr. Anne M Gregas, O.D.NPI 1770540080
Title
Optometrist
Phone
(321) 253-3550

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
Optometrist 152W00000X OPC 2792 FL Primary

Addresses

Primary practice location

3200 N Wickham Rd
Ste 1
Melbourne, FL 32935-2321

Mailing address

3200 N Wickham Rd
Ste 1
Melbourne, FL 32935-2321
Phone (321) 253-3550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170207002047 FL Part B Supplier - Clinic/Group Practice 7911280409 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

3200 N Wickham Rd
Ste 1
Melbourne, FL 32935
Phone (321) 253-3550

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1376085308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N WICKHAM RD",
            "address_2": "STE 1",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352321",
            "telephone_number": "321-253-3550",
            "fax_number": "321-253-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 N WICKHAM RD",
            "address_2": "STE 1",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352321",
            "telephone_number": "321-253-3550",
            "fax_number": "321-253-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE IN BREVARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "GREGAS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "321-253-3550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.