Individual provider Active NPI

Haley Ehren Fineberg, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1972779809
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC0002904 Issued in FL
Practice address
1652 SW 103Rd LN
Davie, FL 33324-7467
Phone
(954) 474-5520
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC0002904 FL Primary

Addresses

Primary practice location

1652 SW 103Rd LN
Davie, FL 33324-7467

Mailing address

1652 SW 103Rd LN
Davie, FL 33324-7467
Phone (954) 474-5520

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
I20230517003573 FL Practitioner - Optometry 0648636670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC0002904FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark a. Gendal, O.D., P.a. Optometrist CurrentSince Apr 13, 2023 Accepting new patients

Locations

2059 N University Dr
Coral Springs, FL 33071
Phone (954) 752-0589

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1972779809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 SW 103RD LN",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247467",
            "telephone_number": "954-474-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 SW 103RD LN",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247467",
            "telephone_number": "954-474-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINEBERG",
        "first_name": "HALEY",
        "middle_name": "EHREN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC0002904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.