NPIMap

Organization Active NPI

Marc E Bosem MD PA

Doing business as CorrectVision Laser Institute

  • Ophthalmic Technician/Technologist
  • Weston, FL
National Provider Identifier
1386790939
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
ME0067977 Issued in FL
Legal business name
MARC E BOSEM MD PA
Doing business as
CorrectVision Laser Institute
Practice address
2300 N Commerce Pkwy Ste 308
Weston, FL 33326-3256
Phone
(954) 442-1133
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Dr. Marc E Bosem, M.D.NPI 1013951839
Title
Director
Phone
(954) 437-9300

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
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X ME0067977 FL Primary

Addresses

Primary practice location

2300 N Commerce Pkwy Ste 308
Weston, FL 33326-3256

Mailing address

2300 N Commerce Pkwy Ste 308
Weston, FL 33326-3256
Phone (954) 442-1133

Other practice location 1

1 SW 129th Ave
suite 209
Pembroke Pines, FL 33027-1761
Phone (954) 437-9300

Other practice location 2

3850 Hollywood Blvd Ste 203
Hollywood, FL 33021-6700
Phone (954) 442-1133

Other practice location 3

1801 N University Dr Ste 102
Coral Springs, FL 33071-6078
Phone (954) 442-1133

Other identifiers 3

IdentifierTypeStateIssuer
1801857685OtherFLDR. KHAN NPI
378399500MedicaidFL
1710929039OtherFLDR. MAX CORNDORF

Other names 1

  • CorrectVision Laser Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000878 FL Part B Supplier - Clinic/Group Practice 8022914761 Receives reassigned benefits from 10 practitioners
Practice locations: Aventura, FL; Coral Springs, FL; Deerfield Beach, FL; Fort Lauderdale, FL; Hollywood, FL; Miramar, FL; Pembroke Pines, FL; Weston, FL

National Provider Directory

National Provider Directory
Tax ID family
Correctvision Laser Inst2 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.

Locations

1 SW 129th Ave
Ste 209
Pembroke Pines, FL 33027
Phone (954) 437-9300

1600 Sawgrass Corporate Pkwy
Ste 140
Sunrise, FL 33323

2300 N Commerce Pkwy
Ste 308
Weston, FL 33326
Phone (954) 384-8300

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1386790939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N COMMERCE PKWY STE 308",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263256",
            "telephone_number": "954-442-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N COMMERCE PKWY STE 308",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263256",
            "telephone_number": "954-442-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 SW 129th Ave",
            "address_2": "suite 209",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330271761",
            "country_code": "US",
            "telephone_number": "954-437-9300",
            "fax_number": "954-437-9377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 Hollywood Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330216700",
            "country_code": "US",
            "telephone_number": "954-442-1133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 N University Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330716078",
            "country_code": "US",
            "telephone_number": "954-442-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARC E BOSEM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "BOSEM",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-437-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "FL",
            "license": "ME0067977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. KHAN NPI",
            "identifier": "1801857685",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378399500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. MAX CORNDORF",
            "identifier": "1710929039",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CorrectVision Laser Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CorrectVision Laser Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weston, FL

Sources for this page

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