Individual provider Active NPI

Michael B Haugen, OD

  • Optometrist
  • Palm Beach Gardens, FL
National Provider Identifier
1902896558
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 2181 Issued in FL
Practice address
11380 Prosperity Farms Rd
Suite 119
Palm Beach Gardens, FL 33410-3464
Phone
(561) 627-1114
Fax
(561) 627-2304
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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 2181 FL Primary

Addresses

Primary practice location

11380 Prosperity Farms Rd
Suite 119
Palm Beach Gardens, FL 33410-3464

Mailing address

11380 Prosperity Farms Rd
Suite 119
Palm Beach Gardens, FL 33410-3464
Phone (561) 627-1114

Other identifiers 1

IdentifierTypeStateIssuer
078980100MedicaidFL

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
I20110531000668 FL Practitioner - Optometry 4183738842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aaron J Evans OD PAGroup PAC ID 5193853505, 11 clinicians

Practice addresses (Care Compare)

1705 S Federal Hwy
Suite A8
Delray Beach, FL 33483-3328
Phone (561) 276-5099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 2181FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aaron J. Evans O.D. P.a. Optometrist CurrentSince Jun 12, 2018 Accepting new patients

Locations

5030 Champion Blvd
Ste C2A
Boca Raton, FL 33496
Phone (561) 912-0800

1200 S Rogers Cir
Ste 16
Boca Raton, FL 33487

333 Plaza Real
Boca Raton, FL 33432
Phone (561) 392-8383

21334 Saint Andrews Blvd
Boca Raton, FL 33433
Phone (561) 576-2654

2344 N University Dr
Coral Springs, FL 33065
Phone (954) 344-3937

302 E Atlantic Ave
Ste 1B
Delray Beach, FL 33483
Phone (561) 279-4444

1705 S Federal Hwy
Ste A8
Delray Beach, FL 33483
Phone (561) 274-0672

14917 Lyons Rd
Ste 108
Delray Beach, FL 33446
Phone (561) 501-5346

15332 NW 79th Ct
Miami Lakes, FL 33016
Phone (305) 821-0304

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1902896558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD",
            "address_2": "SUITE 119",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103464",
            "telephone_number": "561-627-1114",
            "fax_number": "561-627-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD",
            "address_2": "SUITE 119",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103464",
            "telephone_number": "561-627-1114",
            "fax_number": "561-627-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078980100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.