Individual provider Active NPI

Liliana Betancourt, O.D.

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1689762213
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FL2826 Issued in FL
Practice address
17782 SW 2ND St
Pembroke Pines, FL 33029-3923
Phone
(954) 438-3937
Fax
(954) 430-5770
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X FL2826 FL Primary

Addresses

Primary practice location

17782 SW 2ND St
Pembroke Pines, FL 33029-3923

Mailing address

17782 SW 2ND St
Pembroke Pines, FL 33029-3923
Phone (954) 438-3937

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
I20130104000225 FL Practitioner - Optometry 7719133354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Betancourt-McIver OD PAGroup PAC ID 4284880816, 2 clinicians

Practice addresses (Care Compare)

17782 SW 2ND St
Pembroke Pines, FL 33029-3923
Phone (954) 438-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL2826FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Betancourt-McIver OD PA Optometrist CurrentSince Sep 5, 2012 Accepting new patients
I Stuart McIver OD PLLC Optometrist PastSince Sep 5, 2012 Accepting new patients

Locations

17782 SW 2nd St
Pembroke Pines, FL 33029
Phone (954) 438-3937

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1689762213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17782 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293923",
            "telephone_number": "954-438-3937",
            "fax_number": "954-430-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17782 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293923",
            "telephone_number": "954-438-3937",
            "fax_number": "954-430-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "LILIANA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.