Individual provider Active NPI

Corinne Chick, OD

  • Optometrist
  • Santa Barbara, CA
National Provider Identifier
1033637574
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33791TLG Issued in CA
Practice address
3855 State St
Santa Barbara, CA 93105-3152
Phone
(805) 682-5799
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33791TLG CA Primary

Addresses

Primary practice location

3855 State St
Santa Barbara, CA 93105-3152

Mailing address

3855 State St
Santa Barbara, CA 93105-3152

Other practice location 1

555 El Colegio Rd
Santa Barbara, CA 93106-7002
Phone (805) 893-3170

Other names 1

  • Dr. Corinne NG Former name

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
I20181112002081 CA Practitioner - Optometry 2466706346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33791TLGCAMDOptometrist
33791CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Joanne and Tem Gronquist, Inc. Optometrist CurrentSince Jul 7, 2021 Accepting new patients
Clear Vision Optometry Optometrist Past Accepting new patients

Locations

1805 State St
Ste B
Santa Barbara, CA 93101
Phone (805) 569-1504

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1033637574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053152",
            "telephone_number": "805-682-5799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 El Colegio Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931067002",
            "country_code": "US",
            "telephone_number": "805-893-3170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHICK",
        "first_name": "CORINNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33791TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINNE",
            "last_name": "NG",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.