Kevin Thomas Willeford, O.D., M.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPFC96 Issued in FL

Practice address

3200 S University Dr
Davie, FL 33328-2018

Phone

(954) 262-4200

Fax

(954) 262-3217

NPI assigned

Jun 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

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 2

Specialty

Optometry

Education

State University of New York - State College Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Nova Southeastern University, Inc

  • Optometrist
  • Ft. Lauderdale, FL
  • NPI 1700924511
  Medicare reassignment Care Compare group NPD
• State of New York Comptrollers Office

  • Optometrist
  • New York, NY
  • NPI 1407829856
  Medicare reassignment NPD
• Nova Southeastern University Inc.

  • Clinical Medical Laboratory
  • Ft. Lauderdale, FL
  • NPI 1770533390
  NPD
• Nova Southeastern University, Inc

  • Optometrist
  • Davie, FL
  • NPI 1588802169
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517
  NPD (past)

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1922413558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290370",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333290370",
            "telephone_number": "954-262-4200",
            "fax_number": "954-262-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4200",
            "fax_number": "954-262-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEFORD",
        "first_name": "KEVIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008192-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPFC96",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Davie, FL
• Providers in Davie, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.