Individual provider Active NPI

Richard Jay Chesen, O.D.

  • Optometrist
  • Miramar, FL
National Provider Identifier
1528081049
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1627 Issued in FL
Practice address
2909 SW 160TH Ave
Miramar, FL 33027-4212
Phone
(954) 437-9733
Fax
(954) 432-6116
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1627 FL Primary

Addresses

Primary practice location

2909 SW 160TH Ave
Miramar, FL 33027-4212

Mailing address

2909 SW 160TH Ave
Miramar, FL 33027-4212
Phone (954) 437-9733

Other identifiers 1

IdentifierTypeStateIssuer
003876300MedicaidFL

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
I20061108000362 FL Practitioner - Optometry 9739186552 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1627FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
MVRC Inc Optometrist CurrentSince Jul 1, 2016 Accepting new patients
Mirvision Inc Optometrist CurrentSince Mar 1, 2023 Accepting new patients

Locations

2909 SW 160th Ave
Miramar, FL 33027
Phone (954) 437-9733

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1528081049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 SW 160TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274212",
            "telephone_number": "954-437-9733",
            "fax_number": "954-432-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 SW 160TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274212",
            "telephone_number": "954-437-9733",
            "fax_number": "954-432-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESEN",
        "first_name": "RICHARD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "1627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003876300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.