Michael A Corben, O.D.
Individual provider Active NPI Optometrist · Newhall, CA
NPI 1043297666 · NPPES record last updated Nov 28, 2007
Key facts
- NPI
- 1043297666
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4954T (CA)
- Practice address
- 23206 Lyons Ave
Suite 102
Newhall, CA 91321-2667 - Phone
- (661) 259-2168
- NPI assigned
- Dec 23, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 1968
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Corben Optometry Inc
Practice addresses (Care Compare)
23206 Lyons Ave
Suite 102
Newhall, CA 91321-2671
Phone (661) 259-2168
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080111000476 | CA | Practitioner - Optometry | 2567543937 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4954T | CA | MD | Vision Therapy Optometrist |
| 4954 | CA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctors Matthew Alpert and Joshua Corben Optometric Corp | Optometrist | Current |
Accepting new patients |
| Corben Optometry Inc | Optometrist | Current |
Accepting new patients |
Locations
23206 Lyons Ave
Ste 102
Newhall, CA 91321
Phone (661) 259-2168
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4954T | CA | Yes |
| Corneal and Contact Management Optometrist | 152WC0802X | 4954T | CA | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 4954T | CA | |
| Pediatric Optometrist | 152WP0200X | 4954T | CA | |
| Sports Vision Optometrist | 152WS0006X | 4954T | CA | |
| Vision Therapy Optometrist | 152WV0400X | 4954T | CA | |
| Occupational Vision Optometrist | 152WX0102X | 4954T | CA |
Addresses
Primary practice location
23206 Lyons Ave
Suite 102
Newhall, CA 91321-2667
Mailing address
23206 Lyons Ave
Suite 102
Newhall, CA 91321-2667
Phone (661) 259-2168
Other providers in Newhall, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.