Individual provider Active NPI

Charmaine Thomas, O.D.

  • Optometrist
  • Sunrise, FL
National Provider Identifier
1871631135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3624 Issued in FL
Practice address
1396 SW 160TH Ave
Suite #2
Sunrise, FL 33326-1965
Phone
(954) 888-6466
Fax
(954) 888-6681
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3624 FL Primary

Addresses

Primary practice location

1396 SW 160TH Ave
Suite #2
Sunrise, FL 33326-1965

Mailing address

1396 SW 160TH Ave
Suite #2
Sunrise, FL 33326-1965
Phone (954) 888-6466

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
I20060221000626 FL Practitioner - Optometry 2567477169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Thomas OD PA Optometrist CurrentSince Feb 18, 2020 Accepting new patients

Locations

14784 SW 88th St
Miami, FL 33196
Phone (305) 383-3399

1396 SW 160th Ave
Ste 2
Sunrise, FL 33326
Phone (954) 349-2733

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871631135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1396 SW 160TH AVE",
            "address_2": "SUITE #2",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261965",
            "telephone_number": "954-888-6466",
            "fax_number": "954-888-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1396 SW 160TH AVE",
            "address_2": "SUITE #2",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261965",
            "telephone_number": "954-888-6466",
            "fax_number": "954-888-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHARMAINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.