Individual provider Active NPI

Barry S Pivnick, O.D.

  • Optometrist
  • Boynton Beach, FL
National Provider Identifier
1649304775
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
667 Issued in CT
Practice address
6712 Southport Dr
Boynton Beach, FL 33437-6921
Phone
(561) 737-8183
NPI assigned
Mar 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 667 CT Primary

Addresses

Primary practice location

6712 Southport Dr
Boynton Beach, FL 33437-6921

Mailing address

6712 Southport Dr
Boynton Beach, FL 33437-6921
Phone (561) 737-8183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040419000005 CT Practitioner - Optometry 5890780977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Westfarms Eye Associates PC Optometrist CurrentSince Dec 1, 2011 Accepting new patients
Luxottica of America Inc Past Accepting new patients
King Family Eye Care, LLC Optometrist Past Accepting new patients
Town Line Eye Care, LLC Optometrist Past Accepting new patients

Locations

2691 Berlin Tpke
Newington, CT 06111
Phone (860) 594-4585

Organizations & group practices 4

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649304775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 SOUTHPORT DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376921",
            "telephone_number": "561-737-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712 SOUTHPORT DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376921",
            "telephone_number": "561-737-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIVNICK",
        "first_name": "BARRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.