Organization Active NPI

Eye Surgeon & Consultants PA

  • Ophthalmology Physician
  • Hollywood, FL
National Provider Identifier
1649376914
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE SURGEON & CONSULTANTS PA
Practice address
4651 Sheridan St
Suite 100
Hollywood, FL 33021-3457
Phone
(954) 894-1500
Fax
(954) 894-1526
NPI assigned
Sep 15, 2006
Last updated
Jan 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Delain Joyce
Title
Credentialing Coordinator
Phone
(954) 894-1500

Specialties & licenses 1

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

Addresses

Primary practice location

4651 Sheridan St
Suite 100
Hollywood, FL 33021-3457

Mailing address

4651 Sheridan St
Suite 100
Hollywood, FL 33021-3457
Phone (954) 894-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061228000128 FL Part B Supplier - Clinic/Group Practice 6507866449 Receives reassigned benefits from 3 practitioners
Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory

Locations

4651 Sheridan St
Ste 10
Hollywood, FL 33021

4651 Sheridan St
Ste 100
Hollywood, FL 33021
Phone (954) 894-1500

Practitioners & affiliated clinicians

Practitioners 4

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1649376914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 SHERIDAN ST",
            "address_2": "SUITE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213457",
            "telephone_number": "954-894-1500",
            "fax_number": "954-894-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SHERIDAN ST",
            "address_2": "SUITE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213457",
            "telephone_number": "954-894-1500",
            "fax_number": "954-894-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGEON & CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "JOYCE",
        "authorized_official_first_name": "DELAIN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "954-894-1500"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.