Individual provider Active NPI

Nicolas Gilberg, OD

  • Optometrist
  • North Miami, FL
National Provider Identifier
1700191244
Registry record updated Dec 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4531 Issued in FL
Practice address
14711 Biscayne Blvd Ste 308
North Miami, FL 33181-1213
Phone
(786) 500-2020
NPI assigned
Aug 9, 2010
Last updated
Dec 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001984 VA
Optometrist 152W00000X OPC4531 FL Primary

Addresses

Primary practice location

14711 Biscayne Blvd Ste 308
North Miami, FL 33181-1213

Mailing address

13100 Coronado Dr
North Miami, FL 33181-2154
Phone (786) 500-2020

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
I20110725000471 FL Practitioner - Optometry 3375711070 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001984VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Herman L de Anna OD PA Optometrist CurrentSince Dec 29, 2016 Accepting new patients

Locations

1625 W 49th St
Hialeah, FL 33012
Phone (305) 364-3879

7100 W 20th Ave
Ste 702
Hialeah, FL 33016
Phone (305) 825-3005

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": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544313600000",
    "number": "1700191244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 CORONADO DR",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331812154",
            "telephone_number": "786-500-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14711 BISCAYNE BLVD STE 308",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331811213",
            "telephone_number": "786-500-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERG",
        "first_name": "NICOLAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2018-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001984",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.