Ilya Ginzburg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5199 Issued in FL

Practice address

4975 SW 148TH Ave
Davie, FL 33330-2419

Phone

(267) 307-2098

NPI assigned

Jun 14, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1558711192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122936",
            "telephone_number": "305-825-7227",
            "fax_number": "305-825-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4975 SW 148TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302419",
            "telephone_number": "267-307-2098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1777 W 49th St",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330122936",
            "country_code": "US",
            "telephone_number": "305-825-7227",
            "fax_number": "305-825-7233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GINZBURG",
        "first_name": "ILYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James Giordano
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• Nadine M Girgis - Hanna, O.D.
• Gja Investment LLC
• Shatiana Glasper

• Optometrist in Davie, FL
• Providers in Davie, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.