Broadway Family Optometry
NPI 1265101158ActiveOrganization· Optometrist· Glendale, CA
Optometrist in Glendale, California, registered in NPPES in September 2021. The authorized official on file is Boris Mardian, OD, Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1265101158 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 13, 2021 |
| Last updated in NPPES | Sep 13, 2021 |
| Certified by provider | Sep 13, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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