Individual provider Active NPI

Magnum Bien Aime, LDO

  • Optician
  • Boca Raton, FL
National Provider Identifier
1689283160
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
6822 Issued in FL
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
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
6822FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyewear R US LLC Optician CurrentSince Apr 10, 2022 Accepting new patients
Eye-Wear Glasses III Inc PastSince Feb 1, 2022 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 and National Provider Directory roles.

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.

Verify at the official NPI Registry.