Organization Active NPI

Bhakta Optometric, Inc

  • Optometrist
  • Lake Worth, FL
National Provider Identifier
1417265455
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4297 Issued in FL
Legal business name
BHAKTA OPTOMETRIC, INC
Practice address
8755 Hypoluxo Rd Ste 2
Lake Worth, FL 33467-5316
Phone
(978) 457-0557
NPI assigned
Sep 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Dr. Hetel Bhakta, O.D.NPI 1831332519
Title
Optometrist
Phone
(978) 457-0557

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 OPC 4297 FL Primary

Addresses

Primary practice location

8755 Hypoluxo Rd Ste 2
Lake Worth, FL 33467-5316

Mailing address

8755 Hypoluxo Rd Ste 2
Lake Worth, FL 33467-5316
Phone (978) 457-0557

Other practice location 1

6841 Miramar Pkwy
Miramar, FL 33023-6023
Phone (305) 735-1730

Other identifiers 2

IdentifierTypeStateIssuer
001645200MedicaidFL
BV5192OtherFLMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL None

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110110000700 FL Part B Supplier - Clinic/Group Practice 4688863483 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Worth, FL

National Provider Directory

National Provider Directory

Locations

8755 Hypoluxo Rd
Ste 2
Lake Worth, FL 33467
Phone (561) 965-7600

Practitioners & affiliated clinicians

Practitioners 4

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": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1417265455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8755 HYPOLUXO RD STE 2",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334675316",
            "telephone_number": "978-457-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8755 HYPOLUXO RD STE 2",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334675316",
            "telephone_number": "978-457-0557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6841 Miramar Pkwy",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330236023",
            "country_code": "US",
            "telephone_number": "305-735-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BHAKTA OPTOMETRIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "BHAKTA",
        "authorized_official_first_name": "HETEL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "978-457-0557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001645200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BV5192",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "None",
            "affiliation": "N",
            "address_1": "8755 Hypoluxo Rd Ste 2",
            "city": "Lake Worth",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334675316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.