Individual provider Active NPI

Jacqueline Rosenberg, OD

  • Optometrist
  • Stuart, FL
National Provider Identifier
1457818320
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5895 Issued in FL
Practice address
3173 S Kanner Hwy
Stuart, FL 34994-4822
Phone
(772) 324-4832
Fax
(772) 324-4833
NPI assigned
Feb 26, 2019
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5895 FL Primary

Addresses

Primary practice location

3173 S Kanner Hwy
Stuart, FL 34994-4822

Mailing address

3594 Old Lighthouse Cir
Wellington, FL 33414-8841
Phone (561) 213-2774

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
I20230323000581 FL Practitioner - Optometry 9638543168 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aaron J. Evans O.D. P.a. Optometrist CurrentSince Jan 18, 2023 Accepting new patients
Fraser Optical Clinic, Inc. Optometrist Past Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist PastSince Jun 1, 2024 Accepting new patients

Locations

1200 S Rogers Cir
Ste 16
Boca Raton, FL 33487

333 Plaza Real
Boca Raton, FL 33432
Phone (561) 392-8383

5030 Champion Blvd
Ste C2A
Boca Raton, FL 33496
Phone (561) 912-0800

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": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1457818320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3594 OLD LIGHTHOUSE CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148841",
            "telephone_number": "561-213-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3173 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944822",
            "telephone_number": "772-324-4832",
            "fax_number": "772-324-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JACQUELINE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.