Individual provider Active NPI

Judy Chifen Dassler, OD

  • Optometrist
  • Surfside, FL
National Provider Identifier
1578738159
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC0003322 Issued in FL
Practice address
9543 Harding Ave
Surfside, FL 33154-2501
Phone
(305) 866-7247
Fax
(305) 866-4005
NPI assigned
Apr 24, 2008
Last updated
Apr 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC0003322 FL Primary

Addresses

Primary practice location

9543 Harding Ave
Surfside, FL 33154-2501

Mailing address

9543 Harding Ave
Surfside, FL 33154-2501
Phone (305) 866-7247

Other identifiers 1

IdentifierTypeStateIssuer
621214000MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC0003322FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Past Accepting new patients

Organizations & group practices 2

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1578738159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9543 HARDING AVE",
            "city": "SURFSIDE",
            "state": "FL",
            "postal_code": "331542501",
            "telephone_number": "305-866-7247",
            "fax_number": "305-866-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9543 HARDING AVE",
            "city": "SURFSIDE",
            "state": "FL",
            "postal_code": "331542501",
            "telephone_number": "305-866-7247",
            "fax_number": "305-866-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASSLER",
        "first_name": "JUDY",
        "middle_name": "CHIFEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC0003322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621214000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surfside, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.