Hassan Tavakkoli, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

OS 6626 Issued in FL

Practice address

8051 W. Sunrise Blvd
Plantation, FL 33322

Phone

(954) 474-2900

Fax

(954) 474-2901

NPI assigned

Nov 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Michigan State University College of Osteopathic Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Physicians of Florida LLPGroup PAC ID 1254414675, 42 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: hassan.tavakkolidophd.p23@direct.eyefl.nextgenshare.com

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.

• Eye Physicians of Florida LLP

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1770763799
  Medicare reassignment Care Compare group
• South Florida Laser Eye Center

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1346294113
  NPD (past) Authorized official
• Fort Lauderdale Eye Institute

  • Ophthalmology Physician
  • Plantation, FL
  • NPI 1558475400
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1932380441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 39209",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "33339",
            "telephone_number": "954-851-9966",
            "fax_number": "954-318-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8051 W. SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33322",
            "telephone_number": "954-474-2900",
            "fax_number": "954-474-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKKOLI",
        "first_name": "HASSAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS 6626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0853300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "650505235",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "375397200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80799",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "235914",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375397200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hassan.tavakkolidophd.p23@direct.eyefl.nextgenshare.com",
            "affiliation": "N",
            "address_1": "8051 W. Sunrise Blvd",
            "city": "Plantation",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tartell & Mandel MD LLC
• Paul Brenden Tartell, M.D.
• Basheer Tashtoush, MD
• Rosalie F Tassone, MD
• Elizabeth Siria Tatum, MOT, OTR/L
• Bertha Lucia Tavarez, PSY.D.
• Elizabeth Tavernari, ARNP
• Jenee Taylor
• Shari Taylor
• Stephen Michael Taylor, CRNA

• Ophthalmology Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.