Individual provider Active NPI

Aldyn Charbonneau, OD

  • Optometrist
  • Bradenton, FL
National Provider Identifier
1891522397
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6559 Issued in FL
Practice address
2003 Cortez Rd W
Bradenton, FL 34207-1241
Phone
(941) 756-2020
NPI assigned
Sep 18, 2024
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6559 FL Primary

Addresses

Primary practice location

2003 Cortez Rd W
Bradenton, FL 34207-1241

Mailing address

2003 Cortez Rd W
Bradenton, FL 34207-1241
Phone (941) 756-2020

Other practice location 1

8312 US Highway 301 N Ste 105
Parrish, FL 34219-8725
Phone (941) 776-5770

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
I20241011000545 FL Practitioner - Optometry 2163954470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Center IncGroup PAC ID 8325093677, 9 clinicians

Practice addresses (Care Compare)

2003 Cortez Rd W
Bradenton, FL 34207-1289
Phone (941) 756-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Center Inc Optometrist CurrentSince Oct 15, 2024 Accepting new patients
Eye Center Inc Optometrist CurrentSince Oct 15, 2024 Accepting new patients
Eye Center Inc Optometrist Past Accepting new patients

Locations

2003 Cortez Rd W
Bradenton, FL 34207
Phone (941) 756-2020

8312 US Highway 301 N
Ste 105
Parrish, FL 34219
Phone (941) 776-5770

Organizations & group practices 3

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1891522397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071241",
            "telephone_number": "941-756-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342071241",
            "telephone_number": "941-756-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8312 US Highway 301 N Ste 105",
            "address_purpose": "LOCATION",
            "city": "Parrish",
            "state": "FL",
            "postal_code": "342198725",
            "country_code": "US",
            "telephone_number": "941-776-5770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "ALDYN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.