William Braeske Dreyer Jr., M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME 35786 Issued in FL

Practice address

1715 SE Tiffany Ave
Port Saint Lucie, FL 34952-7520

Phone

(772) 337-2020

Fax

(772) 337-1704

NPI assigned

Dec 10, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1821327412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 SW RACQUET CLUB DR",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902303",
            "telephone_number": "772-286-6880",
            "fax_number": "772-382-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 SE TIFFANY AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527520",
            "telephone_number": "772-337-2020",
            "fax_number": "772-337-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYER",
        "first_name": "WILLIAM",
        "middle_name": "BRAESKE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-10",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME 35786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180010527",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039720200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.