Individual provider Active NPI

Lawrence Sider, OD

  • Optometrist
  • Boca Raton, FL
National Provider Identifier
1700992203
Registry record updated Jul 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1693 Issued in FL
Practice address
2200 Glades Rd
Suite 105
Boca Raton, FL 33431-7309
Phone
(561) 226-4920
Fax
(561) 988-9325
NPI assigned
Aug 21, 2006
Last updated
Jul 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1693 FL Primary

Addresses

Primary practice location

2200 Glades Rd
Suite 105
Boca Raton, FL 33431-7309

Mailing address

2200 Glades Rd
Suite 105
Boca Raton, FL 33431-7309
Phone (561) 226-4920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NV2 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
I20050114000070 FL Practitioner - Optometry 0648229997
I20190221000139 NV Practitioner - Optometry 0648229997 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC1693FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kopolow & Girisgen Professional Corporation Optometrist CurrentSince Jan 7, 2019 Accepting new patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Jan 7, 2019 Accepting new patients
Aeg Florida Professional PLLC Optometrist PastSince Jun 25, 2025 Accepting new patients
Lawrence Sider OD PA Optometrist PastSince Apr 1, 1991 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

75 S Valle Verde Dr
Ste 120
Henderson, NV 89012

2021 N Rainbow Blvd
Ste 100
Las Vegas, NV 89108
Phone (702) 515-0200

4045 Spencer St
Ste A59
Las Vegas, NV 89119
Phone (702) 437-5521

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128
Phone (702) 341-7254

5465 Meadowood Mall Cir
Reno, NV 89502
Phone (775) 826-4100

Organizations & group practices 6

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372896000000",
    "number": "1700992203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GLADES RD",
            "address_2": "SUITE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317309",
            "telephone_number": "561-226-4920",
            "fax_number": "561-988-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GLADES RD",
            "address_2": "SUITE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317309",
            "telephone_number": "561-226-4920",
            "fax_number": "561-988-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDER",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.