Mary Underberg Charbonneau, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3406 Issued in FL

Practice address

501 N Navy Blvd
Vision Center
Pensacola, FL 32507-2011

Phone

(850) 426-1747

Fax

(850) 453-6617

NPI assigned

Jun 14, 2006

Sex

Female

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 1

Other names 1

• Mary Underberg Rosenbaum Former name

Medicare fee-for-service enrollment

Enrolled in FL, AL2 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

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr C Vision Care PLLCGroup PAC ID 3971919705, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.charbonneau@uprisedirect.com
• Direct secure messaging: marycharbonneau@ecc.allscriptsdirect.net

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.

• Dr C Vision Care PLLC

  • Optometrist
  • Pensacola, FL
  • NPI 1326631979
  Medicare reassignment Care Compare group NPD
• Escambia Community Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Pensacola, FL
  • NPI 1518971597
  Medicare reassignment NPD
• Coastal Family Eyecare Inc

  • Optometrist
  • Orange Beach, AL
  • NPI 1457416562

  FL

  Medicare reassignment NPD
• Escambia Community Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Pensacola, FL
  • NPI 1841487634
  NPD
• Escambia Community Clinics, Inc

  • Federally Qualified Health Center (FQHC)
  • Pensacola, FL
  • NPI 1629789466
  NPD
• Dr. Muneer Hanna and Associates PA

  • Vision Therapy Optometrist
  • Jacksonville, FL
  • NPI 1760654016
  NPD (past)
• Ernst Nicolitz MD PA

  • Legal Medicine
  • Jacksonville, FL
  • NPI 1033128152
  NPD (past)
• Southpoint Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
  • NPI 1477500767
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1962445189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N NAVY BLVD",
            "address_2": "VISION CENTER",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325072011",
            "telephone_number": "850-426-1747",
            "fax_number": "850-453-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N NAVY BLVD",
            "address_2": "VISION CENTER",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325072011",
            "telephone_number": "850-426-1747",
            "fax_number": "850-453-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "MARY",
        "middle_name": "UNDERBERG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003499800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ROSENBAUM",
            "middle_name": "UNDERBERG",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeri Rose Chandler, CRNA
• Leo C Chandler
• Charles Emory Chapleau, M.D.
• Vivian Chapman
• Charles Alan Charbonneau, O.D.
• Charles E Chapleau M D Neurosurgery PLLC
• Charles P. Riley MD PA
• Elizabeth Rose Charles, LMHC
• Lashica Shartrece Charley, M.S,
• Charlie Delta Health Service LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.