Individual provider Active NPI

N Scott Gorman

  • Optometrist
  • North Miami Beach, FL
National Provider Identifier
1578637310
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1086 Issued in FL
Practice address
1825 NE 164TH St
North Miami Beach, FL 33162-4100
Phone
(305) 945-7113
NPI assigned
Nov 20, 2006
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1086 FL Primary

Addresses

Primary practice location

1825 NE 164TH St
North Miami Beach, FL 33162-4100

Mailing address

3150 NE 190TH St Apt 104
Aventura, FL 33180-3175
Phone (954) 806-8446

Other practice location 1

1711 NE 163rd St
North Miami Beach, FL 33162-4732
Phone (305) 945-7301

Other identifiers 1

IdentifierTypeStateIssuer
084468300MedicaidFL

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
I20041025000477 FL Practitioner - Optometry 6507827342 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC1086FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Eye Institute, PA Optometrist CurrentSince Jan 6, 2023 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jan 23, 2024 Accepting new patients
Myeyedr. Optometry of Florida, LLC Optometrist CurrentSince Jan 23, 2024 Accepting new patients
Eye Doctors Optical Outlets, PA Optometrist Past Accepting new patients

Locations

3011 W Yamato Rd
Ste A19
Boca Raton, FL 33434
Phone (561) 995-9600

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

2305 Oleander Blvd
Fort Pierce, FL 34982
Phone (772) 465-6616

9375 66th St N
Pinellas Park, FL 33782
Phone (727) 541-4469

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1578637310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 NE 190TH ST APT 104",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803175",
            "telephone_number": "954-806-8446",
            "fax_number": "866-382-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 NE 164TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624100",
            "telephone_number": "305-945-7113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1711 NE 163rd St",
            "address_purpose": "LOCATION",
            "city": "North Miami Beach",
            "state": "FL",
            "postal_code": "331624732",
            "country_code": "US",
            "telephone_number": "305-945-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "N",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084468300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.