NPIMap

Organization Active NPI

Fort Lauderdale Eye Institute

  • Ophthalmology Physician
  • Plantation, FL
National Provider Identifier
1558475400
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
FORT LAUDERDALE EYE INSTITUTE
Practice address
850 S Pine Island Rd
Suite A100
Plantation, FL 33324-3118
Phone
(954) 741-5555
Fax
(954) 572-9658
NPI assigned
Aug 18, 2006
Last updated
Jan 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Authorized official

Name
Keith Skolnick, M.D.NPI 1851393581
Title
Owner
Phone
(954) 741-5555

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU
Ophthalmology Physician 207W00000X FL Primary

Addresses

Primary practice location

850 S Pine Island Rd
Suite A100
Plantation, FL 33324-3118

Mailing address

PO Box 39209
Ft Lauderdale, FL 33339-9209
Phone (954) 741-5555

Other identifiers 2

IdentifierTypeStateIssuer
250805200MedicaidFL
40276OtherBLUE CROSS BLUE SHEILD

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
10D1023258Fort Lauderdale Eye Institute850 S Pine Island Rd, Ste A100, Plantation, FL 33324Certificate of waiverMar 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Fort Lauderdale Eye Institute2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

850 S Pine Island Rd
#100
Plantation, FL 33324

850 S Pine Island Rd
Ste A100
Plantation, FL 33324
Phone (954) 741-5555

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1558475400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39209",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333399209",
            "telephone_number": "954-741-5555",
            "fax_number": "954-572-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S PINE ISLAND RD",
            "address_2": "SUITE A100",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243118",
            "telephone_number": "954-741-5555",
            "fax_number": "954-572-9658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LAUDERDALE EYE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "SKOLNICK",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-741-5555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250805200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "40276",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.