Individual provider Active NPI

Renaye Barnes Quintyne, O.D.

  • Optometrist
  • West Palm Beach, FL
National Provider Identifier
1962546242
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3775 Issued in FL
Practice address
1703 Palm Beach Lakes Blvd Unit B01
West Palm Beach, FL 33401-2031
Phone
(561) 615-5638
Fax
(561) 615-5639
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 06387T TX
Optometrist 152W00000X 3775 FL Primary

Addresses

Primary practice location

1703 Palm Beach Lakes Blvd Unit B01
West Palm Beach, FL 33401-2031

Mailing address

1703 Palm Beach Lakes Blvd Unit B01
West Palm Beach, FL 33401-2031
Phone (954) 873-8649

Other identifiers 1

IdentifierTypeStateIssuer
620858400MedicaidFL

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000007 FL Practitioner - Optometry 3870491491 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3775FLMDClinical Social Worker
06387TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Jan 11, 2015 Accepting new patients
National Vision, Inc. PastSince Jan 11, 2015 Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

5237 Summerlin Commons Blvd
#333
Fort Myers, FL 33907
Phone (239) 275-2241

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

2241 Tamiami Trl
Port Charlotte, FL 33948
Phone (941) 629-9309

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1962546242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 PALM BEACH LAKES BLVD UNIT B01",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012031",
            "telephone_number": "954-873-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 PALM BEACH LAKES BLVD UNIT B01",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012031",
            "telephone_number": "561-615-5638",
            "fax_number": "561-615-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTYNE",
        "first_name": "RENAYE",
        "middle_name": "BARNES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06387T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620858400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.