Organization Active NPI

Manatee Family Eyecare, PA

  • Optometrist
  • Bradenton, FL
National Provider Identifier
1710161047
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MANATEE FAMILY EYECARE, PA
Practice address
7423 Manatee Ave W Ste B
Bradenton, FL 34209-3403
Phone
(941) 792-7522
Fax
(941) 798-3713
NPI assigned
Dec 21, 2007
Last updated
Jul 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Warren A Paquin Jr., ODNPI 1629128350
Title
Vice President
Phone
(941) 792-7522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

7423 Manatee Ave W Ste B
Bradenton, FL 34209-3403

Mailing address

501 Village Green Pkwy Ste 3
Bradenton, FL 34209-3401
Phone (941) 792-7522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110330000383 FL Part B Supplier - Clinic/Group Practice 1658491469 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bradenton, FL; Palmetto, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Manatee Family Eyecare PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

501 Village Green Pkwy
Ste 3
Bradenton, FL 34209
Phone (941) 351-9440

7423 Manatee Ave W
Ste B
Bradenton, FL 34209
Phone (941) 792-7522

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1710161047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 VILLAGE GREEN PKWY STE 3",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093401",
            "telephone_number": "941-792-7522",
            "fax_number": "941-798-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7423 MANATEE AVE W STE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093403",
            "telephone_number": "941-792-7522",
            "fax_number": "941-798-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANATEE FAMILY EYECARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "PAQUIN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "941-792-7522",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.