Individual provider Active NPI

Brian Rex Alcalde, O.D.

  • Optometrist
  • La Puente, CA
National Provider Identifier
1013035443
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13191T Issued in CA
Practice address
1641 N Hacienda Blvd
La Puente, CA 91744-1137
Phone
(626) 918-1407
Fax
(626) 918-2069
NPI assigned
Mar 26, 2007
Last updated
Jul 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13191T CA Primary

Addresses

Primary practice location

1641 N Hacienda Blvd
La Puente, CA 91744-1137

Mailing address

165 S Jeanine Way
Anaheim, CA 92806-3840
Phone (714) 322-9520

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090106000125 CA Practitioner - Optometry 6204999030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13191TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chino Optometry Center Optometrist CurrentSince Jul 28, 2015 Accepting new patients
Clear Sight Optometry Corp Optometrist PastSince May 12, 2008 Accepting new patients
Andrew G Chong, O.D. Optometrist Past Accepting new patients

Locations

11640 Central Ave
Chino, CA 91710
Phone (909) 627-7363

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1013035443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S JEANINE WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928063840",
            "telephone_number": "714-322-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 N HACIENDA BLVD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441137",
            "telephone_number": "626-918-1407",
            "fax_number": "626-918-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCALDE",
        "first_name": "BRIAN",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13191T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

Verify at the official NPI Registry.