Active NPI
Magnum Bien Aime, LDO
- Optician
- Boca Raton, FL
National Provider Identifier
1689283160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 6822
- Practice address
- 122 W Palmetto Park Rd
Boca Raton, FL 33432-3828 - Phone
- (561) 368-5844
- Fax
- (561) 368-5844
- NPI assigned
- Jul 30, 2020
- Last updated
- Jan 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 6822 | FL | Primary |
Addresses
Primary practice location
122 W Palmetto Park Rd
Boca Raton, FL 33432-3828
Mailing address
122 W Palmetto Park Rd
Boca Raton, FL 33432-3828
Phone (561) 368-5844
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | eyewearus1@gmail.com |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6822 | FL | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyewear R US LLC | Optician | Current | Accepting new patients |
| Eye-Wear Glasses III Inc | Past | Accepting new patients |
Locations
122 W Palmetto Park Rd
Boca Raton, FL 33432
Phone (561) 368-5844
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, 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": "1596067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643155200000",
"number": "1689283160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 W PALMETTO PARK RD",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334323828",
"telephone_number": "561-368-5844",
"fax_number": "561-368-6681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 W PALMETTO PARK RD",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334323828",
"telephone_number": "561-368-5844",
"fax_number": "561-368-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIEN AIME",
"first_name": "MAGNUM",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-30",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "6822",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "eyewearus1@gmail.com",
"affiliation": "N",
"endpointDescription": "email address",
"address_1": "122 W Palmetto Park Rd",
"city": "Boca Raton",
"state": "FL",
"country_code": "US",
"postal_code": "334323828",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.