Marina Ishak Abdalla, OD
Individual provider Active NPI Optometrist · Weston, FL
NPI 1720573173 · NPPES record last updated Mar 28, 2021
Key facts
- NPI
- 1720573173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPC5527 (FL)
- Practice address
- 2863 Executive Park Dr Ste 103
Weston, FL 33331-3647 - Phone
- (954) 440-7242
- NPI assigned
- Jun 28, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
55 Weston Rd
Suite 105
Weston, FL 33326-1112
Phone (954) 440-7242
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200207000822 | FL | Practitioner - Optometry | 8527494657 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC5527 | FL | MD | Optometrist |
| TA2629 | MD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marina Abdalla LLC | Optometrist | Current |
Accepting new patients |
| Nova Southeastern University, Inc | Optometrist | Current | Accepting new patients |
| Nova Southeastern University, Inc | Current |
Accepting new patients | |
| Nova Southeastern University Inc. | Current |
Accepting new patients | |
| Appelbaum Eyecare Associates | Past |
Accepting new patients | |
| H.F.M. O.D. Inc | Past |
Accepting new patients |
Locations
650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213
1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000
55 Weston Rd
Ste 105
Weston, FL 33326
Phone (954) 389-9600
819 NE 26th St
Wilton Manors, FL 33305
Phone (954) 390-7654
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC5527 | FL | Yes |
| Optometrist | 152W00000X | TA2629 | MD |
Addresses
Primary practice location
2863 Executive Park Dr Ste 103
Weston, FL 33331-3647
Mailing address
747 Sunflower Cir
Weston, FL 33327-2113
Other practice location 1
133 Defense Hwy Ste 133
Annapolis, MD 21401-7098
Phone (301) 897-8484
Other practice location 2
6509 Democracy Blvd
Bethesda, MD 20817-1639
Phone (301) 897-8484
Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.