Individual provider Active NPI

Ivanka Acosta, OD

  • Optometrist
  • Miami, FL
National Provider Identifier
1972377612
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6378 Issued in FL
Practice address
3825 NW 7TH St
Miami, FL 33126-5502
Phone
(305) 554-0693
NPI assigned
Nov 13, 2023
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6378 FL Primary

Addresses

Primary practice location

3825 NW 7TH St
Miami, FL 33126-5502

Mailing address

3940 NW 79TH Ave Apt 307
Doral, FL 33166-6581
Phone (305) 748-5185

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
I20240711004521 FL Practitioner - Optometry 4789129990 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6378FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressive Eyes LLC Optometrist CurrentSince Jun 19, 2024 Accepting new patients

Locations

15601 SW 127th Ave
Miami, FL 33177
Phone (305) 964-3852

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1972377612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 NW 79TH AVE APT 307",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666581",
            "telephone_number": "305-748-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 NW 7TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331265502",
            "telephone_number": "305-554-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "IVANKA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.