Organization Active NPI

Maged S. Habib, M.D. P.a.

  • Eyewear Supplier
  • Boynton Beach, FL
National Provider Identifier
1578735379
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
ME77394 Issued in FL
Legal business name
MAGED S. HABIB, M.D. P.A.
Practice address
2300 S Congress Ave
Suite 102
Boynton Beach, FL 33426-7400
Phone
(561) 742-1944
Fax
(561) 742-0525
NPI assigned
Apr 1, 2008
Last updated
Jun 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Teresa M Davis
Title
Office Manager
Phone
(561) 742-1944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X ME77394 FL Primary

Addresses

Primary practice location

2300 S Congress Ave
Suite 102
Boynton Beach, FL 33426-7400

Mailing address

2300 S Congress Ave
Suite 102
Boynton Beach, FL 33426-7400
Phone (561) 742-1944

Other identifiers 1

IdentifierTypeStateIssuer
257361000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120703000140 FL Part B Supplier - Clinic/Group Practice 9931317666 Receives reassigned benefits from 6 practitioners
Practice locations: Boynton Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1578735379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S CONGRESS AVE",
            "address_2": "SUITE 102",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267400",
            "telephone_number": "561-742-1944",
            "fax_number": "561-742-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S CONGRESS AVE",
            "address_2": "SUITE 102",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267400",
            "telephone_number": "561-742-1944",
            "fax_number": "561-742-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGED S. HABIB, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "561-742-1944"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "ME77394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257361000",
            "state": "FL"
        }
    ],
    "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 Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.