Individual provider Active NPI

Carmen Perez, OD

  • Optometrist
  • Davie, FL
National Provider Identifier
1659001501
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6070 Issued in FL
Practice address
3301 College Ave
Davie, FL 33314-7721
Phone
(800) 541-6682
NPI assigned
Jun 14, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6070 FL Primary

Addresses

Primary practice location

3301 College Ave
Davie, FL 33314-7721

Mailing address

1924 SW 94TH CT
Miami, FL 33165-7712

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
I20220725002013 FL Practitioner - Optometry 8224419031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

3200 S University Dr
Daive, FL 33328-2018
Phone (954) 262-4343

Merit-based Incentive Payment System (MIPS)

Final score
72.47 of 100Reported as group
Quality
62.45
Improvement activities
40
Cost
73.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6070FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University CurrentSince Jul 15, 2022 Accepting new patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University Inc. CurrentSince Jul 15, 2022 Accepting new patients
Nova Southeastern University, Inc Optometrist Past Accepting new patients

Locations

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200

3301 College Ave
Davie, FL 33314
Phone (800) 541-6682

1111 W Broward Blvd
Ft Lauderdale, FL 33312
Phone (954) 463-7313

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

5901 Del Lago Cir
Sunrise, FL 33313
Phone 9544634217 ext. 122

Networks

  • Freedom Health HMO Network

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1659001501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 SW 94TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 COLLEGE AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147721",
            "telephone_number": "800-541-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CARMEN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.