NPIMap

Organization Active NPI

Vitreo Retinal Consultants of the Palm Beaches PA

  • Ophthalmology Physician
  • West Palm Beach, FL
National Provider Identifier
1871550996
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
VITREO RETINAL CONSULTANTS OF THE PALM BEACHES PA
Practice address
2521 Metrocentre Blvd
West Palm Beach, FL 33407
Phone
(561) 687-0007
Fax
(561) 688-0431
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Authorized official

Name
Mr. Salomon Emilio Melgen, MD
Title
President of Corporation
Phone
(561) 687-0007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2521 Metrocentre Blvd
West Palm Beach, FL 33407

Mailing address

2521 Metrocentre Blvd
West Palm Beach, FL 33407
Phone (561) 687-0007

Other identifiers 2

IdentifierTypeStateIssuer
56172OtherFLBLUE CROSS BLUE SHIELD
064710100MedicaidFL

National Provider Directory

National Provider Directory

Locations

6290 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-1337

2521 Metrocentre Blvd
West Palm Beach, FL 33407
Phone (407) 687-0007

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1871550996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 METROCENTRE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-687-0007",
            "fax_number": "561-688-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 METROCENTRE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-687-0007",
            "fax_number": "561-688-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITREO RETINAL CONSULTANTS OF THE PALM BEACHES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "MELGEN",
        "authorized_official_first_name": "SALOMON",
        "authorized_official_middle_name": "EMILIO",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "561-687-0007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56172",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064710100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.