Allyn Jacobson OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1033 Issued in FL

Legal business name

ALLYN JACOBSON OD PA

Practice address

9529 SW 160TH St
Miami, FL 33157-3350

Phone

(305) 238-2121

Fax

(305) 238-2123

NPI assigned

Oct 21, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Allyn Howard Jacobson, ODNPI 1972684405

Title

Optometrist

Phone

(305) 238-2121

Specialties & licenses 1

Addresses

Other names 1

• Allyn Jacobsom OD Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Allyn Howard Jacobson, O.D.

  • Corneal and Contact Management Optometrist
  • Miami, FL
  • NPI 1972684405
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1376915066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9529 SW 160TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573350",
            "telephone_number": "305-238-2121",
            "fax_number": "305-238-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9529 SW 160TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331573350",
            "telephone_number": "305-238-2121",
            "fax_number": "305-238-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLYN JACOBSON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "ALLYN",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "305-238-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allyn Jacobsom OD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Optometrist in Miami, FL
• Providers in Miami, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.