Individual provider Active NPI

Laura Angela Falco, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1396819132
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3462 Issued in FL
Practice address
2279 S University Dr
Davie, FL 33324-5828
Phone
(954) 473-0100
Fax
(954) 262-1818
NPI assigned
Nov 20, 2006
Last updated
Sep 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3462 FL Primary

Addresses

Primary practice location

2279 S University Dr
Davie, FL 33324-5828

Mailing address

2279 S University Dr
Davie, FL 33324-5828
Phone (954) 473-0100

Other identifiers 1

IdentifierTypeStateIssuer
620566600MedicaidFL

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
I20120507000498 FL Practitioner - Optometry 0648432708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Laura Falco OD LLCGroup PAC ID 1153655527, 2 clinicians

Practice addresses (Care Compare)

2279 S University Dr
Davie, FL 33324-5828
Phone (954) 473-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3462FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Falco, O.D. LLC Optometrist CurrentSince Oct 3, 2018 Accepting new patients
Nova Southeastern University CurrentSince Oct 1, 2000 Accepting new patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University Inc. CurrentSince Oct 1, 2000 Accepting new patients

Locations

2279 S University Dr
Davie, FL 33324
Phone (954) 473-0100

3200 S University Dr
Ste 1402
Davie, FL 33328
Phone (954) 262-1402

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1396819132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333245828",
            "telephone_number": "954-473-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333245828",
            "telephone_number": "954-473-0100",
            "fax_number": "954-262-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCO",
        "first_name": "LAURA",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620566600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.