Individual provider Active NPI

Warren A. Paquin, O.D.

  • Optometrist
  • Palmetto, FL
National Provider Identifier
1629128350
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 2420 Issued in FL
Practice address
319 7TH St W
Palmetto, FL 34221-5206
Phone
(941) 729-5516
Fax
(941) 729-3736
NPI assigned
Jan 12, 2007
Last updated
Jun 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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 2420 FL Primary

Addresses

Primary practice location

319 7TH St W
Palmetto, FL 34221-5206

Mailing address

6809 Riverview Blvd
Bradenton, FL 34209-1246
Phone (941) 729-5516

Other identifiers 2

IdentifierTypeStateIssuer
078985200MedicaidFL
078975500MedicaidFL

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
I20110330000431 FL Practitioner - Optometry 7113031972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manatee Family Eyecare, PAGroup PAC ID 1658491469, 2 clinicians

Practice addresses (Care Compare)

319 7TH St W
Palmetto, FL 34221-5206
Phone (941) 729-5516

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 2420FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Manatee Family Eyecare, PA Optometrist Current Accepting new patients
Manatee Family Eyecare, PA Optometrist CurrentSince Dec 21, 1990 Accepting new patients

Locations

501 Village Green Pkwy
Ste 3
Bradenton, FL 34209
Phone (941) 351-9440

319 7th St W
Palmetto, FL 34221
Phone (813) 729-5516

1236 Jacaranda Blvd
Venice, FL 34292
Phone (941) 496-4444

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1629128350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 RIVERVIEW BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342091246",
            "telephone_number": "941-729-5516",
            "fax_number": "941-729-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 7TH ST W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215206",
            "telephone_number": "941-729-5516",
            "fax_number": "941-729-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUIN",
        "first_name": "WARREN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078985200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078975500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.