Individual provider Active NPI

Andrew D Chen, OD

  • Optometrist
  • Miami, FL
National Provider Identifier
1780756742
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3220 Issued in FL
Practice address
12091 SW 152ND St
Miami, FL 33177-1607
Phone
(305) 232-3937
Fax
(305) 232-3936
NPI assigned
Nov 14, 2006
Last updated
Sep 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 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 OPC3220 FL Primary

Addresses

Primary practice location

12091 SW 152ND St
Miami, FL 33177-1607

Mailing address

12091 SW 152ND St
Miami, FL 33177-1607
Phone (305) 232-3937

Other identifiers 1

IdentifierTypeStateIssuer
OPC3220OtherFLMEDICAL LICENSE

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
I20090423000388 FL Practitioner - Optometry 9133277577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye N Eye IncGroup PAC ID 4880863448, 2 clinicians

Practice addresses (Care Compare)

12091 SW 152 St
Miami, FL 33177-1607
Phone (305) 232-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3220FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye N Eye Inc Optometrist CurrentSince Mar 7, 2011 Accepting new patients

Locations

12091 SW 152nd St
Miami, FL 33177
Phone (305) 232-3937

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1780756742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12091 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771607",
            "telephone_number": "305-232-3937",
            "fax_number": "305-232-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12091 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771607",
            "telephone_number": "305-232-3937",
            "fax_number": "305-232-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OPC3220",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.