Provider Demographics
NPI:1164494464
Name:CASS, ANDREW STEVEN (OD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:STEVEN
Last Name:CASS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 CAYMAN WAY
Mailing Address - Street 2:C4
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-3203
Mailing Address - Country:US
Mailing Address - Phone:954-234-4453
Mailing Address - Fax:954-978-0664
Practice Address - Street 1:1502 CAYMAN WAY
Practice Address - Street 2:C4
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-3203
Practice Address - Country:US
Practice Address - Phone:954-234-4453
Practice Address - Fax:954-978-0664
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006815152W00000X
FLOPC3879152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5C4301OtherHEALTH NET
NY02650219Medicaid
NYC4086OtherBLUE CROSS
NYC357A1Medicare ID - Type Unspecified
NY02650219Medicaid
FLV02355Medicare UPIN