Dr Ryan Verxagio OD PA

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

OPC3957 Issued in FL

Legal business name

DR RYAN VERXAGIO OD PA

Practice address

1315 Silk Oak Dr
Hollywood, FL 33021-1367

Phone

(305) 439-2015

Fax

(305) 503-9250

NPI assigned

Dec 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Carlo Verxagio, O.D.NPI 1669432969

Title

President

Phone

(305) 439-2015

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan C Verxagio, OD

  • Optometrist
  • Hollywood, FL
  • NPI 1669432969

  Low Vision Rehabilitation

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677369600000",
    "number": "1932438124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 SILK OAK DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211367",
            "telephone_number": "305-439-2015",
            "fax_number": "305-503-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 SILK OAK DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211367",
            "telephone_number": "305-439-2015",
            "fax_number": "305-503-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RYAN VERXAGIO OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "VERXAGIO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "CARLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-439-2015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "FL",
            "license": "OPC3957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621009100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Low Vision Rehabilitation Optometrist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Low Vision Rehabilitation Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.