Individual provider Active NPI

Glenda Aleman Moheeputh, OD

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1689187676
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008707 Issued in NY
Practice address
19244 NW 12TH St
Pembroke Pines, FL 33029-4500
Phone
(954) 854-7910
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008707 NY Primary

Addresses

Primary practice location

19244 NW 12TH St
Pembroke Pines, FL 33029-4500

Mailing address

19244 NW 12TH St
Pembroke Pines, FL 33029-4500
Phone (954) 854-7910

Other names 1

  • Glenda Lourdes Aleman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180426002154 NY Practitioner - Optometry 6002170180 Reassigns benefits to 1 organization
I20220111000933 FL Practitioner - Optometry 6002170180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center, Inc CurrentSince Mar 13, 2018 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Mar 13, 2018 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

3039 Route 50
Saratoga Springs, NY 12866
Phone (518) 580-1117

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 2

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1689187676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19244 NW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294500",
            "telephone_number": "954-854-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19244 NW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294500",
            "telephone_number": "954-854-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHEEPUTH",
        "first_name": "GLENDA",
        "middle_name": "ALEMAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "ALEMAN",
            "middle_name": "LOURDES",
            "credential": "LDO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.