Individual provider Active NPI

Jacquelyn M. Lopez, O.D.

  • Optometrist
  • Miami, FL
National Provider Identifier
1609259134
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 5092 Issued in FL
Practice address
12139 S Dixie Hwy
Miami, FL 33156-5200
Phone
(305) 256-2525
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 5092 FL Primary

Addresses

Primary practice location

12139 S Dixie Hwy
Miami, FL 33156-5200

Mailing address

12139 S Dixie Hwy
Miami, FL 33156-5200

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
I20170419002828 FL Practitioner - Optometry 9133405525 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michelle Levin OD PAGroup PAC ID 8527342112, 6 clinicians

Practice addresses (Care Compare)

777 E 25TH St
Suite 414
Hialeah, FL 33013-3835
Phone (305) 835-7588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 5092FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Vision Care Inc Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Michelle Levin OD PA Optometrist CurrentSince Dec 1, 2016 Accepting new patients
Lopez Eye Care PA Optometrist CurrentSince Mar 24, 2025 Accepting new patients
DRS. Cukierman & Gomez, Inc Optometrist CurrentSince Feb 15, 2025 Accepting new patients
DRS. Cukierman & Gomez, Inc Optometrist Current Accepting new patients
Gary P Gegerson, O.D.,P.a. Optometrist Past Accepting new patients

Locations

3773 W Flagler St
Coral Gables, FL 33134
Phone (304) 400-8035

2873 Stirling Rd
Ft Lauderdale, FL 33312
Phone (954) 983-4969

777 E 25th St
Ste 414
Hialeah, FL 33013
Phone (305) 835-7588

246 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 442-4602

1608 Town Center Blvd
Ste C
Weston, FL 33326
Phone (954) 384-1127

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1609259134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12139 S DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12139 S DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565200",
            "telephone_number": "305-256-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JACQUELYN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.