Dean Kenton Amundsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 7925 TPA Issued in CA

Practice address

2460 N Ponderosa Dr
Suite a-101
Camarillo, CA 93010-2398

Phone

(805) 482-1136

Fax

(805) 388-8499

NPI assigned

May 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

Southern California College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dean Amundsen OD Professional Optometry CorpGroup PAC ID 8527962232, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.56 of 100Reported as individual

Quality

99.12

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dean Amundsen,O.D. Professional Optometry Corp.

  • Optometrist
  • Camarillo, CA
  • NPI 1750353637
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003021205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 N PONDEROSA DR",
            "address_2": "SUITE A-101",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102398",
            "telephone_number": "805-482-1136",
            "fax_number": "805-388-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N PONDEROSA DR",
            "address_2": "SUITE A-101",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102398",
            "telephone_number": "805-482-1136",
            "fax_number": "805-388-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSEN",
        "first_name": "DEAN",
        "middle_name": "KENTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 7925 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.