Organization Active NPI

Boca Family Eye Care, LLC

  • Optometrist
  • Boca Raton, FL
National Provider Identifier
1962790972
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BOCA FAMILY EYE CARE, LLC
Practice address
9858 Clint Moore Rd
Boca Raton, FL 33496-1034
Phone
(561) 479-0521
Fax
(561) 479-0522
NPI assigned
Jul 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Dr. Jonathan T Nebb, ODNPI 1437397866
Title
Co-Owner
Phone
(703) 447-1644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X FL Primary

Addresses

Primary practice location

9858 Clint Moore Rd
Boca Raton, FL 33496-1034

Mailing address

9858 Clint Moore Rd
Boca Raton, FL 33496-1034
Phone (561) 479-0521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110930000077 FL Part B Supplier - Clinic/Group Practice 0345412045 Receives reassigned benefits from 6 practitioners
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory
Tax ID family
Boca Family Eye Care2 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.

Locations

9858 Clint Moore Rd
Ste C107
Boca Raton, FL 33496
Phone (561) 479-0521

9858 Clint Moore Rd
Ste 107
Boca Raton, FL 33496
Phone (203) 606-4256

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1962790972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9858 CLINT MOORE RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334961034",
            "telephone_number": "561-479-0521",
            "fax_number": "561-479-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9858 CLINT MOORE RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334961034",
            "telephone_number": "561-479-0521",
            "fax_number": "561-479-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "NEBB",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "703-447-1644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.