Organization Active NPI

Pinnacle Eye Center Inc

  • Ophthalmology Physician
  • Melbourne, FL
National Provider Identifier
1629062401
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PINNACLE EYE CENTER INC
Practice address
1649 W Eau Gallie Blvd
Ste 100
Melbourne, FL 32935-4160
Phone
(321) 255-4949
Fax
(321) 255-0887
NPI assigned
Sep 7, 2005
Last updated
Jul 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Authorized official

Name
Regine M Pappas, MDNPI 1215921275
Title
Medical Director / Owner
Phone
(321) 255-4949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1649 W Eau Gallie Blvd
Ste 100
Melbourne, FL 32935-4160

Mailing address

1649 W Eau Gallie Blvd
Ste 100
Melbourne, FL 32935-4160
Phone (321) 255-4949

Other identifiers 1

IdentifierTypeStateIssuer
004604900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050926000864 FL Part B Supplier - Clinic/Group Practice 0840224127 Receives reassigned benefits from 3 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

1649 W Eau Gallie Blvd
Ste 100
Melbourne, FL 32935
Phone (321) 255-4949

Interoperability endpoints

  • Direct secure messaging: apappas@pineye.intellechartdirect.net
  • Direct secure messaging: jpappas@pineye.intellechartdirect.net
  • Direct secure messaging: rpappas@pineye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 6

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": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1629062401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 W EAU GALLIE BLVD",
            "address_2": "STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354160",
            "telephone_number": "321-255-4949",
            "fax_number": "321-255-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 W EAU GALLIE BLVD",
            "address_2": "STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354160",
            "telephone_number": "321-255-4949",
            "fax_number": "321-255-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "REGINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "321-255-4949",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004604900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.