Individual provider Active NPI

Edward Leslie Boshnick, OD

  • Optometrist
  • Miami, FL
National Provider Identifier
1497818561
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
909 Issued in FL
Practice address
7800 SW 87TH Ave
Suite B-270
Miami, FL 33173-3570
Phone
(305) 271-8206
Fax
(305) 271-8209
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 909 FL Primary

Addresses

Primary practice location

7800 SW 87TH Ave
Suite B-270
Miami, FL 33173-3570

Mailing address

9960 SW 129 St
Miami, FL 33176
Phone (305) 232-2093

Other identifiers 2

IdentifierTypeStateIssuer
084349100MedicaidFL
3052644400OtherFLDR BOSHNICK VISION PLAN

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
I20160701000215 FL Order and Referring Only - OptometryPractitioner - Optometry 8426237728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
909FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1497818561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9960 SW 129 ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33176",
            "telephone_number": "305-232-2093",
            "fax_number": "305-233-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SW 87TH AVE",
            "address_2": "SUITE B-270",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733570",
            "telephone_number": "305-271-8206",
            "fax_number": "305-271-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSHNICK",
        "first_name": "EDWARD",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084349100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR BOSHNICK VISION PLAN",
            "identifier": "3052644400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.