Lori Johnson Bende, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10611T Issued in CA

Practice address

4009 Governor Dr
San Diego, CA 92122-2522

Phone

(858) 453-0444

NPI assigned

Mar 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Illinois College of Optometry at Chicago, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gordon Schanzlin New Vision Institute, Inc. a Professional Medical CorGroup PAC ID 1557655230, 9 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Gordon Schanzlin New Vision Institute, Inc. a Professional Medical Cor

  • Optometrist
  • San Diego, CA
  • NPI 1134573678
  Medicare reassignment Care Compare group NPD
• Carmel Mountain Vision Care Optometry, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1922103688
  Medicare reassignment NPD
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003944968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 GOVERNOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222522",
            "telephone_number": "858-453-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 GOVERNOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222522",
            "telephone_number": "858-453-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDE",
        "first_name": "LORI",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10611T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVP SAFEGURAD PROVIDER NU",
            "identifier": "50322",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES PROV",
            "identifier": "13089",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jean Bench, AGPCNP
• Shawn Robert Bench, MD
• Ma Olivia Dablo Bencito, RN
• Angela Bencke, ANP -BC
• Grace Benda
• Julian Bendelstein, MD
• Ashlei Bender Smith
• Allyson Bender
• Carol Joy Bender, R.N.P.
• Cole Bender

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.