Individual provider Active NPI

David Wayne Rouse, O.D.

  • Optometrist
  • Sunrise, FL
National Provider Identifier
1720047574
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP2683 Issued in FL
Practice address
15916 W State Road 84
Sunrise, FL 33326-1226
Phone
(954) 384-6200
Fax
(954) 384-0506
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2683 DC
Optometrist 152W00000X OP2683 FL Primary

Addresses

Primary practice location

15916 W State Road 84
Sunrise, FL 33326-1226

Mailing address

15908 West State Road 84
Sunrise, FL 33326-1233
Phone (954) 384-6200

Other identifiers 1

IdentifierTypeStateIssuer
086891400MedicaidFL

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
I20101207001167 FL Practitioner - Optometry 4385838168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rouse Family Eye Care, PAGroup PAC ID 2769676543, 2 clinicians

Practice addresses (Care Compare)

15916 W State Rd
Suite 84
Sunrise, FL 33326-1226
Phone (954) 384-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2683DCMDOptometrist
OP2683FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rouse Family Eye Care, P.a. Optometrist CurrentSince Jul 27, 2010 Accepting new patients

Locations

15908 W State Road 84
Sunrise, FL 33326
Phone (954) 384-6200

15916 W State Road 84
Sunrise, FL 33326
Phone (954) 384-6200

Organizations & group practices 1

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1720047574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15908 WEST STATE ROAD 84",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261233",
            "telephone_number": "954-384-6200",
            "fax_number": "954-384-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15916 W STATE ROAD 84",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261226",
            "telephone_number": "954-384-6200",
            "fax_number": "954-384-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "2683",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP2683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086891400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.