Individual provider Active NPI

Vivienne Laura Rosenbusch, OD

  • Optometrist
  • Boca Raton, FL
National Provider Identifier
1508048547
Registry record updated Dec 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2721 Issued in FL
Practice address
2901 Clint Moore Rd
Suite 8
Boca Raton, FL 33496-2041
Phone
(561) 241-5665
Fax
(561) 241-5489
NPI assigned
Dec 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2721 FL Primary

Addresses

Primary practice location

2901 Clint Moore Rd
Suite 8
Boca Raton, FL 33496-2041

Mailing address

2901 Clint Moore Rd
Suite 8
Boca Raton, FL 33496-2041
Phone (561) 241-5665

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
I20040204000327 FL Practitioner - Optometry 6103719182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2901 Clint Moore Rd
Suite 8
Boca Raton, FL 33496-2044
Phone (561) 241-5665

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2721FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visioncare Unlimited, Inc. Optometrist CurrentSince Oct 12, 1993 Accepting new patients
Pga Eye Associates,LLC Optometrist PastSince Aug 1, 2005 Accepting new patients

Locations

2901 Clint Moore Rd
Ste 8
Boca Raton, FL 33496
Phone (321) 241-5665

Organizations & group practices 2

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": "1196467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196467200000",
    "number": "1508048547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CLINT MOORE RD",
            "address_2": "SUITE 8",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962041",
            "telephone_number": "561-241-5665",
            "fax_number": "561-241-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 CLINT MOORE RD",
            "address_2": "SUITE 8",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962041",
            "telephone_number": "561-241-5665",
            "fax_number": "561-241-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBUSCH",
        "first_name": "VIVIENNE",
        "middle_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-01",
        "last_updated": "2007-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.