Organization Active NPI

Palm Beach Eye Center Inc

  • Ophthalmology Physician
  • Lake Worth, FL
National Provider Identifier
1497753305
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0092488 Issued in FL
Legal business name
PALM BEACH EYE CENTER INC
Practice address
5057 S Congress Ave
Lake Worth, FL 33461-4723
Phone
(561) 433-5200
Fax
(561) 433-5206
NPI assigned
Jul 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Jay S Wallshein, M.D.NPI 1669476693
Title
President
Phone
(561) 433-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X ME0092488 FL Primary

Addresses

Primary practice location

5057 S Congress Ave
Lake Worth, FL 33461-4723

Mailing address

5057 S Congress Ave
Suite 403
Lake Worth, FL 33461-4723
Phone (561) 433-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050511000230 FL Part B Supplier - Clinic/Group Practice 6901846757 Receives reassigned benefits from 13 practitioners
Practice locations: Delray Beach, FL; West Palm Beach, FL; Wellington, FL; The Villages, FL; Lakeland, FL; Lake Worth, FL; Boca Raton, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2082954Palm Beach Eye Center Inc5057 S Congress Ave Ste 403, Lake Worth, FL 33461Certificate of waiverAug 25, 2026

National Provider Directory

National Provider Directory

Locations

2900 N Military Trl
Ste 247
Boca Raton, FL 33431
Phone (561) 391-9661

2623 S Seacrest Blvd
Ste 102
Boynton Beach, FL 33435
Phone (561) 734-5056

5057 S Congress Ave
Lake Worth, FL 33461
Phone (561) 433-5200

401 S Florida Ave
Lakeland, FL 33801
Phone (833) 983-9389

3319 S State Road 7
Ste 205
Wellington, FL 33449
Phone (561) 788-4455

Networks

  • HealthSun Health Plans Network

Interoperability endpoints

  • Direct secure messaging: sfair@vippbec.intellechartdirect.net
  • Direct secure messaging: posathanugrah@vippbec.intellechartdirect.net
  • Direct secure messaging: rraden@vippbec.intellechartdirect.net
  • Direct secure messaging: mmartinez@vippbec.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1497753305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5057 S CONGRESS AVE",
            "address_2": "SUITE 403",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614723",
            "telephone_number": "561-433-5200",
            "fax_number": "561-433-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5057 S CONGRESS AVE",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614723",
            "telephone_number": "561-433-5200",
            "fax_number": "561-433-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "WALLSHEIN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-433-5200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0092488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.