Bradley Callister, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

33717TLG Issued in CA

Practice address

140 Avenida del Mar
San Clemente, CA 92672-4016

Phone

(949) 492-1853

NPI assigned

Jun 27, 2017

Last updated

Feb 11, 2019By 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 College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

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.

• Total Vision PC

  dba Total Vision

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Medicare reassignment Care Compare group NPD
• James R Henslick,O.D. Professional Corporation

  • Optometrist
  • Laguna Niguel, CA
  • NPI 1770559874
  NPD (past)
• Seal Beach Eyes Optometry Inc

  • Optometrist
  • Seal Beach, CA
  • NPI 1124171566
  NPD (past)
• Steven T Klein OD & Kimberly Plattner OD a Professional Corporation

  dba Total Vision Care Advanced Optometry

  • Optometrist
  • San Diego, CA
  • NPI 1861529703
  NPD (past)

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1033639349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 AVENIDA DEL MAR",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 AVENIDA DEL MAR",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724016",
            "telephone_number": "949-492-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISTER",
        "first_name": "BRADLEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33717TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Sabin Cabanillas, M.A., LMHC, LPCC
• Shanelle Cabral
• California Foot & Ankle Assoc, Inc
• California Rehabilitation & Sports Therapy a California Physical Ther
• Marissa Calise
• Victoria Camacho, FNP-C
• Alexander Michael Cambra, RBT
• Camino Health Center
• Charles H Campbell, MFT
• Tracy Watson Campbell, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.