Active NPI
Joseph G. Siegel, O. D.
- Optometrist
- Sherman Oaks, CA
National Provider Identifier
1023145687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 7350 TPA
- Practice address
- 13350 Ventura Blvd
Sherman Oaks, CA 91423-3939 - Phone
- (818) 788-1770
- NPI assigned
- Feb 28, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 7350 TPA | CA | Primary |
Addresses
Primary practice location
13350 Ventura Blvd
Sherman Oaks, CA 91423-3939
Mailing address
13350 Ventura Blvd
Sherman Oaks, CA 91423-3939
Phone (818) 788-1770
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0073500 | Medicaid | CA | |
| 3843714 | Medicaid | CA | |
| 3803 | Other | CA | MESC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 7350 TPA | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1023145687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13350 VENTURA BLVD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914233939",
"telephone_number": "818-788-1770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13350 VENTURA BLVD",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914233939",
"telephone_number": "818-788-1770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGEL",
"first_name": "JOSEPH",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "O. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 7350 TPA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0073500",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3843714",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MESC",
"identifier": "3803",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.