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DR. GILLIAN MANCUSO PAULA O.D.
NPI 1972051506
Optometrist in Miami, FL

Active since September 12, 2016PECOS EnrolledAccepts Medicare Assignment
12977 SW 112TH ST, MIAMI, FL 33186(305) 386-3937(305) 386-1494 Get Directions Write a Review

NPPES record last updated: August 30, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Gillian Mancuso Paula O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GILLIAN MANCUSO PAULA O.D. (NPI 1972051506) is an individual optometrist in Miami, Florida, licensed in Florida (OPC5498) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (2016).

NPPES Registry Identity

NPI1972051506
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. GILLIAN MANCUSO PAULACredential: O.D.
Location Address12977 SW 112TH STMiami, FL 33186-4769
Mailing Address625 Park AveNew York, NY 10065-7326 · (212) 249-1976 · Fax (212) 249-3712
Phone(305) 386-3937
Fax(305) 386-1494
Sole ProprietorNo
Medical School CMSNew England College Of OptometryGraduated 2016
Enumeration DateSeptember 12, 2016
Last NPPES UpdateAugust 30, 2021
NPPES CertifiedAugust 30, 2021
✔ NPI 1972051506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in FL · OPC5498✔ Licensed in NY · TUV008424
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
12977 SW 112TH ST, Miami, FL 33186
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gillian Mancuso Paula O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820339369
PECOS Enrollment IDI20190409003316
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Gillian Paula reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

James D Hagen Od PA
Same address
Optometrist
12979 SW 112TH ST
Miami, FL 33186
  • Reassigned Medicare billing, Florida enrollment
  • 4 clinicians in this Medicare group
NPI 1942483144 (305) 386-3937

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
33 services32 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
23 services21 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
17 services17 patients
New patient problem focused exam of visual system 92002
A new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33186 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$75.86 typical visit price
range $18.99 – $150.24
Typical copayment $18.96 (range $4.74 – $37.56)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gillian Paula's NPI number?

The NPI number for Gillian Paula is 1972051506. It was assigned to this individual provider in the NPPES registry on September 12, 2016.

Where is Gillian Paula located?

Gillian Paula practices at 12977 SW 112th St, Miami, FL 33186. The listed phone number is (305) 386-3937.

What is Gillian Paula's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Gillian Paula enrolled in Medicare?

Yes. Gillian Paula is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gillian Paula's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gillian Paula reassigns Medicare benefits to James D Hagen Od PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gillian Paula's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gillian Paula accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Anthem Blue Cross and Blue Shield and Blue Cross Blue Shield of Wyoming and 13 other insurers list Gillian Paula as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gillian Paula was last updated on August 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.