Joseph Convertino, OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3882 Issued in FL

Legal business name

JOSEPH CONVERTINO, OD, PA

Practice address

545 Pine Island Rd
N Fort Myers, FL 33903-3764

Phone

(954) 895-5904

NPI assigned

Jan 15, 2008

Last updated

Jan 7, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Frank Convertino, O.D.NPI 1659479004

Title

Optometrist

Phone

(954) 895-5904

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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.

• Joseph Frank Convertino, OD

  • Optometrist
  • N Fort Myers, FL
  • NPI 1659479004
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1467638841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 PINE ISLAND RD",
            "city": "N FORT MYERS",
            "state": "FL",
            "postal_code": "339033764",
            "telephone_number": "954-895-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 PINE ISLAND RD",
            "city": "N FORT MYERS",
            "state": "FL",
            "postal_code": "339033764",
            "telephone_number": "954-895-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH CONVERTINO, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "CONVERTINO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "954-895-5904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in N Fort Myers, FL
• Providers in N Fort Myers, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.