Individual provider Active NPI

Brandi Marie Frey, O.D.

  • Optometrist
  • Port St Lucie, FL
National Provider Identifier
1821019290
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3619 Issued in FL
Practice address
986 SW Saint Lucie West Blvd
Port St Lucie, FL 34986-1766
Phone
(772) 621-8777
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3619 FL Primary

Addresses

Primary practice location

986 SW Saint Lucie West Blvd
Port St Lucie, FL 34986-1766

Mailing address

210 NW Pleasant Grove Way
Port Saint Lucie, FL 34986
Phone (772) 621-8777

Other identifiers 1

IdentifierTypeStateIssuer
000574800MedicaidFL

Other names 1

  • Dr. Brandi Marie Warburton Professional name

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
I20090220000177 FL Practitioner - Optometry 8527135276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 NW Bethany Dr
Port Saint Lucie, FL 34986-3578
Phone (772) 621-8777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3619FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Eyecare & Optique Optometrist CurrentSince Jun 3, 2009 Accepting new patients
Warburton Frey & Associates P a Optometrist PastSince Feb 1, 2008 Accepting new patients

Locations

300 NW Bethany Dr
Port Saint Lucie, FL 34986
Phone (772) 621-8777

986 SW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 621-8777

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, 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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1821019290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW PLEASANT GROVE WAY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-621-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 SW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861766",
            "telephone_number": "772-621-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "BRANDI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000574800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "WARBURTON",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.