Individual provider Active NPI

Amandip Singh Sappal, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1457467532
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3739 Issued in FL
Practice address
15651 Sheridan St
Suite 1000
Davie, FL 33331-3496
Phone
(954) 252-8885
Fax
(954) 252-8882
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3739 FL Primary
Optometrist 152W00000X 11485T CA

Addresses

Primary practice location

15651 Sheridan St
Suite 1000
Davie, FL 33331-3496

Mailing address

15651 Sheridan St
Suite 1000
Davie, FL 33331-3496
Phone (954) 252-8885

Other identifiers 1

IdentifierTypeStateIssuer
68121OtherFLBLUE CROSS BLUE SHIELD ID

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
I20040804000243 FL Practitioner - Optometry 8820069834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

3200 S University Dr
Daive, FL 33328-2018
Phone (954) 262-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11485TCAMDOptometrist
OPC3739FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University, Inc CurrentSince Feb 28, 2024 Accepting new patients
Nova Southeastern University Inc. CurrentSince Feb 28, 2024 Accepting new patients
Nova Southeastern University, Inc Optometrist Past Accepting new patients

Locations

3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

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

1111 W Broward Blvd
Ft Lauderdale, FL 33312
Phone (954) 463-7313

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457467532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15651 SHERIDAN ST",
            "address_2": "SUITE 1000",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313496",
            "telephone_number": "954-252-8885",
            "fax_number": "954-252-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15651 SHERIDAN ST",
            "address_2": "SUITE 1000",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313496",
            "telephone_number": "954-252-8885",
            "fax_number": "954-252-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPPAL",
        "first_name": "AMANDIP",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3739",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11485T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "68121",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.