Ocular Prosthetics Lab Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

OCULAR PROSTHETICS LAB INC

Practice address

2845 N Harbor City Blvd Ste 2-3
Melbourne, FL 32935-6217

Phone

(321) 259-3847

Fax

(407) 246-0222

NPI assigned

Apr 25, 2007

Last updated

Jun 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Richard Bowen Jr., B.C.O, B.A.D.O.NPI 1053423699

Title

Office Administrator

Phone

(321) 259-3847

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Ocular Prosthetics Lab Inc

  • Prosthetic/Orthotic Supplier
  • Orlando, FL
  • NPI 1750500930

  1759400385

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Ocular Prosthetics Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ocular Prosthetics Lab Inc

  • Prosthetic/Orthotic Supplier
  • Orlando, FL
  • NPI 1750500930
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Richard Bowen Jr., B.C.O., B.A.D.O.

  • Ocularist
  • Orlando, FL
  • NPI 1053423699
  NPD Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1942429154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SOUTH BUMBY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034434",
            "telephone_number": "407-246-5451",
            "fax_number": "407-246-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 N HARBOR CITY BLVD STE 2-3",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356217",
            "telephone_number": "321-259-3847",
            "fax_number": "407-246-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCULAR PROSTHETICS LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "321-259-3847",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "B.C.O, B.A.D.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE INS.",
            "identifier": "NA691",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "M2133",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriela Ocasio Bultron, APRN, FNP-BC
• Anthony Emmanuel Ocasio Cruz, L.AC, DOM
• Oceanbreeze Family Chiropractic & Acupuncture, PLC
• Oceanview Internal Medicine, LLC
• Luis Ochoa
• Jennifer J Odom, PA
• Landon CJ Odom
• Jerrold Ofiana, DPT
• Virgil Ogle
• Josephine Ogoe, L/COTA

• Prosthetic/Orthotic Supplier in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.