Individual provider Active NPI

James Krisel, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1437148756
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 954 Issued in FL
Practice address
6795 Stirling Rd
Davie, FL 33314-7118
Phone
(954) 961-1509
Fax
(954) 961-1604
NPI assigned
Oct 19, 2005
Last updated
Jan 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 954 FL Primary

Addresses

Primary practice location

6795 Stirling Rd
Davie, FL 33314-7118

Mailing address

6795 Stirling Rd
Davie, FL 33314-7118
Phone (954) 961-1509

Other identifiers 2

IdentifierTypeStateIssuer
084184600MedicaidFL
OS-D0626OtherFLBC/BS

Other names 1

  • Dr. James Krisel Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 954FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
James a Krisel OD PA Optometrist PastSince Jul 9, 1990 Accepting new patients
Kathryn a Estevez OD LLC Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1437148756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6795 STIRLING RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147118",
            "telephone_number": "954-961-1509",
            "fax_number": "954-961-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6795 STIRLING RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147118",
            "telephone_number": "954-961-1509",
            "fax_number": "954-961-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISEL",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084184600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "OS-D0626",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "KRISEL",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.