NPIMap

Organization Active NPI

DRS. Cukierman & Gomez, Inc

Doing business as Advanced Vision

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1639676281
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3891 Issued in FL
Legal business name
DRS. CUKIERMAN & GOMEZ, INC
Doing business as
Advanced Vision
Practice address
246 S Flamingo Rd
Pembroke Pines, FL 33027-1721
Phone
(954) 443-1230
Fax
(954) 443-1234
NPI assigned
Apr 10, 2018
Organization subpart
Yes
Parent organization
DRS. CUKIERMAN & GOMEZ, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Dr. Michael Alexander Gomez, ODNPI 1477606366
Title
Vice President
Phone
(954) 471-6453

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
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OPC3891 FL Primary

Addresses

Primary practice location

246 S Flamingo Rd
Pembroke Pines, FL 33027-1721

Mailing address

246 S Flamingo Rd
Pembroke Pines, FL 33027-1721
Phone (954) 443-1230

Other identifiers 1

IdentifierTypeStateIssuer
103620900MedicaidFL

Other names 1

  • Advanced Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190918002359 FL Part B Supplier - Clinic/Group Practice 9436489416 Receives reassigned benefits from 12 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boca Raton, FL; Miami Gardens, FL; Pembroke Pines, FL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
DRS Cukierman Gomez Inc2 organizations share this tax ID, including this one
Part of
DRS Cukierman Gomez Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

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

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1639676281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 S FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271721",
            "telephone_number": "954-443-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 S FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271721",
            "telephone_number": "954-443-1230",
            "fax_number": "954-443-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. CUKIERMAN & GOMEZ, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DRS. CUKIERMAN & GOMEZ, INC",
        "enumeration_date": "2018-04-10",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "954-471-6453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103620900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.