Individual provider Active NPI

Stephen Heiden

  • Optometrist
  • Hollywood, FL
National Provider Identifier
1750575619
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1091 Issued in FL
Practice address
2019A Hollywood Blvd
Hollywood, FL 33020-4509
Phone
(954) 922-5210
Fax
(954) 925-2190
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1091 FL Primary

Addresses

Primary practice location

2019A Hollywood Blvd
Hollywood, FL 33020-4509

Mailing address

2019 Hollywood Blvd
Suite a
Hollywood, FL 33020-4509
Phone (954) 922-5210

Other identifiers 1

IdentifierTypeStateIssuer
084487000MedicaidFL

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
I20071215000248 FL Practitioner - Optometry 0042300956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heiden and Heiden PAGroup PAC ID 9931284445, 2 clinicians

Practice addresses (Care Compare)

2019 Hollywood Blvd
A
Hollywood, FL 33020-4509
Phone (954) 922-5210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1091FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Heiden & Heiden PA Optometrist CurrentSince Mar 8, 1997 Accepting new patients

Locations

2019 Hollywood Blvd
#A
Hollywood, FL 33020
Phone (654) 922-5210

2019A Hollywood Blvd
Hollywood, FL 33020
Phone (954) 922-5210

2019 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 922-5210

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, 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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1750575619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 HOLLYWOOD BLVD",
            "address_2": "SUITE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204509",
            "telephone_number": "954-922-5210",
            "fax_number": "954-925-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019A HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204509",
            "telephone_number": "954-922-5210",
            "fax_number": "954-925-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEN",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "1091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084487000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.