Individual provider Active NPI

Cuc Thi Le, OD

  • Optometrist
  • Pembroke Pines, FL
National Provider Identifier
1770833196
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4752 Issued in FL
Practice address
151 SW 184TH Ave
Pembroke Pines, FL 33029-5465
Phone
(954) 437-8777
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4752 FL Primary

Addresses

Primary practice location

151 SW 184TH Ave
Pembroke Pines, FL 33029-5465

Mailing address

13 Matador LN
Davie, FL 33324-5518
Phone (954) 304-2724

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
I20121017000124 FL Practitioner - Optometry 2961652573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4301 S University Dr
Davie, FL 33328-3002
Phone (954) 424-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Optimum Eye Care P.a. Optometrist CurrentSince Mar 1, 2017 Accepting new patients
Dawn T Van O D P a Optometrist CurrentSince Sep 15, 2012 Accepting new patients

Locations

8794 W Boynton Beach Blvd
Ste 114
Boynton Beach, FL 33472
Phone (561) 509-8502

4301 S University Dr
Davie, FL 33328
Phone (954) 331-3613

151 SW 184th Ave
Pembroke Pines, FL 33029
Phone (954) 437-8777

Organizations & group practices 2

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1770833196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 MATADOR LN",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333245518",
            "telephone_number": "954-304-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SW 184TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330295465",
            "telephone_number": "954-437-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "CUC",
        "middle_name": "THI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.