Active NPI
Deon Rae Erickson, OD
- Optometrist
- Palm Beach Gardens, FL
National Provider Identifier
1659338929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC2628
- Practice address
- 3250 Northlake Blvd
Palm Beach Gardens, FL 33403-1702 - Phone
- (561) 622-9985
- Fax
- (561) 624-6329
- NPI assigned
- Apr 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC2628 | FL | Primary |
Addresses
Primary practice location
3250 Northlake Blvd
Palm Beach Gardens, FL 33403-1702
Mailing address
3615 W Woolbright Rd
Boynton Beach, FL 33436-7244
Phone (561) 734-1887
Other practice location 1
17800 Congress Ave
Boca Raton, FL 33487-1200
Phone (561) 758-2030
Other practice location 2
3615 W Woolbright Rd
Boynton Beach, FL 33436-7244
Phone (561) 734-1887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 084865400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2628 | FL | MD | Addiction (Substance Use Disorder) Counselor |
| OPC2628 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision, Inc. | Past | Accepting new patients | |
| National Vision, Inc. | Past | Accepting new patients | |
| Erickson Costello Butler Erickson Optometrist PA | Optometrist | Past | Accepting new patients |
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.
-
- Optometrist
- Boynton Beach, FL
- NPI 1629250436
-
dba Eyecare Professionals
- Optometrist
- Lantana, FL
- NPI 1982753133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1659338929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3615 W WOOLBRIGHT RD",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334367244",
"telephone_number": "561-734-1887",
"fax_number": "561-736-8991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 NORTHLAKE BLVD",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334031702",
"telephone_number": "561-622-9985",
"fax_number": "561-624-6329"
}
],
"practiceLocations": [
{
"address_1": "17800 Congress Ave",
"address_purpose": "LOCATION",
"city": "Boca Raton",
"state": "FL",
"postal_code": "334871200",
"country_code": "US",
"telephone_number": "561-758-2030",
"fax_number": "561-981-5007",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3615 W Woolbright Rd",
"address_purpose": "LOCATION",
"city": "Boynton Beach",
"state": "FL",
"postal_code": "334367244",
"country_code": "US",
"telephone_number": "561-734-1887",
"fax_number": "561-736-8991",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ERICKSON",
"first_name": "DEON",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-28",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC2628",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "084865400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.