Individual provider Active NPI

Marc Endelson

  • Optician
  • Boynton Beach, FL
National Provider Identifier
1558769844
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
6364 Issued in NY
Practice address
1000 N Congress Ave
Suite 150
Boynton Beach, FL 33426-3338
Phone
(561) 734-3550
NPI assigned
Dec 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 6364 NY Primary

Addresses

Primary practice location

1000 N Congress Ave
Suite 150
Boynton Beach, FL 33426-3338

Mailing address

1000 N Congress Ave
Suite 150
Boynton Beach, FL 33426-3338
Phone (561) 734-3550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6364NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1558769844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N CONGRESS AVE",
            "address_2": "SUITE 150",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263338",
            "telephone_number": "561-734-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N CONGRESS AVE",
            "address_2": "SUITE 150",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263338",
            "telephone_number": "561-734-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDELSON",
        "first_name": "MARC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "6364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.