Individual provider Active NPI

Dan Alan Baggett, O.D.

  • Optometrist
  • Palo Alto, CA
National Provider Identifier
1043352255
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5985T Issued in CA
Practice address
456 S California Ave
Palo Alto, CA 94306-1605
Phone
(650) 617-2020
Fax
(650) 617-4550
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5985T CA Primary

Addresses

Primary practice location

456 S California Ave
Palo Alto, CA 94306-1605

Mailing address

456 S California Ave
Palo Alto, CA 94306-1605
Phone (650) 617-2020

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

LicenseStateTypeSpecialty
5985TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043352255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 S CALIFORNIA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061605",
            "telephone_number": "650-617-2020",
            "fax_number": "650-617-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 S CALIFORNIA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061605",
            "telephone_number": "650-617-2020",
            "fax_number": "650-617-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGETT",
        "first_name": "DAN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5985T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, 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.

Verify at the official NPI Registry.