Individual provider Active NPI

Ryan C Verxagio, OD

  • Optometrist
  • Hollywood, FL
National Provider Identifier
1669432969
Registry record updated Feb 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3957 Issued in FL
Practice address
1315 Silk Oak Dr
Hollywood, FL 33021-1367
Phone
(305) 439-2015
Fax
(305) 503-9250
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X OPC 3957 FL
Optometrist 152W00000X OPC 3957 FL Primary

Addresses

Primary practice location

1315 Silk Oak Dr
Hollywood, FL 33021-1367

Mailing address

1315 Silk Oak Dr
Hollywood, FL 33021-1367
Phone (305) 439-2015

Other identifiers 2

IdentifierTypeStateIssuer
U4879VOtherFLMEDICARE UPIN (BROWARD)
621009100MedicaidFL

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
I20050620000178 FL Practitioner - Optometry 6406890532 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Vision Doctors LLCGroup PAC ID 4385893973, 5 clinicians

Practice addresses (Care Compare)

1315 Silk Oak Dr
Hollywood, FL 33021-1367
Phone (305) 439-2015

2030 S Ocean Dr
Suite 2221
Hallandale Beach, FL 33009-6617
Phone (305) 439-2015

5890 Sw8Th St
The Pointe of North Gables
West Miami, FL 33144-5036
Phone (305) 266-0284

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3957FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Vision Doctors LLC Low Vision Rehabilitation CurrentSince Jul 14, 2012 Accepting new patients
Mobile Doctors of Florida PA Optometrist CurrentSince Oct 15, 2009 Accepting new patients
Dr Ryan Verxagio OD PA Low Vision Rehabilitation CurrentSince Apr 30, 2003 Accepting new patients
Mobile Vision Doctors LLC Low Vision Rehabilitation CurrentSince Jul 14, 2012 Accepting new patients
Vision Doctors Group LLC Optometrist CurrentSince Aug 1, 2025 Accepting new patients

Locations

551 E 49th St
Hialeah, FL 33013
Phone (305) 221-4994

3670 W Oakland Park Blvd
Lauderdale Lakes, FL 33311
Phone (305) 717-8181

10181 Pines Blvd
Pembroke Pines, FL 33026
Phone (302) 823-3312

5890 SW 8th St
West Miami, FL 33144
Phone (305) 266-0284

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677369600000",
    "number": "1669432969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 SILK OAK DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211367",
            "telephone_number": "305-439-2015",
            "fax_number": "305-503-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 SILK OAK DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211367",
            "telephone_number": "305-439-2015",
            "fax_number": "305-503-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERXAGIO",
        "first_name": "RYAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC 3957",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN (BROWARD)",
            "identifier": "U4879V",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621009100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.