Organization Active NPI

Lisa E Nadel OD PA

  • Optometrist
  • Coconut Creek, FL
National Provider Identifier
1417250374
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2624 Issued in FL
Legal business name
LISA E NADEL OD PA
Practice address
6518 N State Road 7
Coconut Creek, FL 33073-3623
Phone
(954) 426-4944
Fax
(954) 426-3109
NPI assigned
Dec 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Mr. Lisa NadelNPI 1780716837
Title
Owner
Phone
(954) 426-4944

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC2624 FL Primary

Addresses

Primary practice location

6518 N State Road 7
Coconut Creek, FL 33073-3623

Mailing address

6518 N State Road 7
Coconut Creek, FL 33073-3623
Phone (954) 426-4944

Other identifiers 1

IdentifierTypeStateIssuer
B4T9FOtherFLORIDA BLUE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120417000344 FL Part B Supplier - Clinic/Group Practice 3476672387 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coconut Creek, FL

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

Locations

6562 N State Road 7
Coconut Creek, FL 33073
Phone (954) 426-4944

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1417250374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6518 N STATE ROAD 7",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733623",
            "telephone_number": "954-426-4944",
            "fax_number": "954-426-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6518 N STATE ROAD 7",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733623",
            "telephone_number": "954-426-4944",
            "fax_number": "954-426-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA E NADEL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "NADEL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-426-4944",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "B4T9F",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.