Organization Active NPI

Scott M Pearl OD PA

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1437362605
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1954 Issued in FL
Legal business name
SCOTT M PEARL OD PA
Practice address
18503 Pines Blvd
Suite 205
Pembroke Pines, FL 33029-1404
Phone
(954) 430-8330
NPI assigned
May 7, 2007
Last updated
Aug 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Dr. Scott M. Pearl, O.D.
Title
President
Phone
(954) 430-8330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1954 FL Primary

Addresses

Primary practice location

18503 Pines Blvd
Suite 205
Pembroke Pines, FL 33029-1404

Mailing address

18503 Pines Blvd
Suite 205
Pembroke Pines, FL 33029-1404
Phone (954) 430-8330

Other identifiers 1

IdentifierTypeStateIssuer
084946400MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1437362605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291404",
            "telephone_number": "954-430-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291404",
            "telephone_number": "954-430-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT M PEARL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "PEARL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-430-8330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084946400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

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