Publix Pharmacy #0655 – Community/Retail Pharmacy, NPI 1720021892

Publix Pharmacy #0655 is a healthcare provider. based in Doral, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0016595 (FL). The NPI Number for Publix Pharmacy #0655 is 1720021892

Main info

Organization
Name
Publix Pharmacy #0655
NPI
1720021892
Phone
(305) 597-1529
Address
10755 NW 58TH ST
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
14 June 2006
Last Update Date
3 December 2019
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Publix Pharmacy #0655

  • 10755, Northwest 58th Street, Doral, Miami-Dade County, Florida, 33178, United States

    DORAL, FL 331782801

    Phone: (305) 597-1529

    Fax: (305) 597-3742

    Type: Location

  • Boom Box Buns, 1324, Main Street, Main Street Business District, Over-the-Rhine, Cincinnati, Hamilton County, Ohio, 45202, United States

    CINCINNATI, OH 452639680

    Phone: (863) 688-1188

    Fax: (863) 616-5846

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-07-31 (318 days ago).

Enrollment records

1

Earliest due date

2025-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930002462OPharmacyFL2025-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine1818$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage1717$0
View full utilization report →

Insurance plans in this area (ZIP 33178)

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Reviews

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Frequently asked questions

What NPI should I save for Publix Pharmacy #0655?
Save NPI 1720021892 if you need a stable reference for Publix Pharmacy #0655.
Is Publix Pharmacy #0655 active in the national directory?
Publix Pharmacy #0655's public NPI profile is in an active state.
What kind of provider is Publix Pharmacy #0655?
The page reflects Community/Retail Pharmacy for Publix Pharmacy #0655. Clinical services aligned with this taxonomy classification.
Where does public data place Publix Pharmacy #0655?
The snapshot lists Doral, Florida for Publix Pharmacy #0655; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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