Individual provider Active NPI

Miriam Halim Farag, O.D.

  • Optometrist
  • Wellington, FL
National Provider Identifier
1801984059
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4021 Issued in FL
Practice address
10443 Trianon PL
Wellington, FL 33449-8075
Phone
(954) 536-8587
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X OPC 4021 FL
Optometrist 152W00000X OPC4021 FL Primary

Addresses

Primary practice location

10443 Trianon PL
Wellington, FL 33449-8075

Mailing address

10443 Trianon PL
Wellington, FL 33449-8075
Phone (954) 536-8587

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
I20080903000459 FL Practitioner - Optometry 1557382587 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4021FLMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Optometrist CurrentSince Jul 1, 2010 Accepting new patients
See Vision Eye Institute PLLC CurrentSince Jul 9, 2024 Accepting new patients
Nova Southeastern University Inc. CurrentSince Jul 1, 2010 Accepting new patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Sightrite Medical FL PLLC Optometrist CurrentSince Nov 1, 2023 Accepting new patients
Palm Beach Eye Center Inc PastSince May 1, 2019 Accepting new patients
University of Miami Past Accepting new patients

Locations

575 Lamar Ave
Brooksville, FL 34601
Phone (352) 799-2226

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

17781 Thelma Ave
Jupiter, FL 33458
Phone (561) 746-2998

5165 S State Road 7
Lake Worth, FL 33449
Phone (561) 621-2020

1800 NE 168th St
North Miami Beach, FL 33162
Phone (305) 917-1800

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

819 NE 26th St
Wilton Manors, FL 33305
Phone (954) 390-7654

267 Broadway
Brooklyn, NY 11211

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

Interoperability endpoints

  • Direct secure messaging: mfarag144390@direct.med.miami.edu

Organizations & group practices 7

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1801984059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10443 TRIANON PL",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498075",
            "telephone_number": "954-536-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10443 TRIANON PL",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498075",
            "telephone_number": "954-536-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAG",
        "first_name": "MIRIAM",
        "middle_name": "HALIM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "OPC 4021",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.