Individual provider Active NPI

Maurice Feldman, OD

  • Optometrist
  • Simi Valley, CA
National Provider Identifier
1053461459
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8224T Issued in CA
Practice address
1420 E Los Angeles Ave
Suite B
Simi Valley, CA 93065-2848
Phone
(805) 526-0842
Fax
(805) 526-1221
NPI assigned
Jan 11, 2007
Last updated
Feb 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8224T CA Primary

Addresses

Primary practice location

1420 E Los Angeles Ave
Suite B
Simi Valley, CA 93065-2848

Mailing address

1420 E Los Angeles Ave
Suite B
Simi Valley, CA 93065-2848
Phone (805) 526-0842

Other identifiers 1

IdentifierTypeStateIssuer
SD0082240MedicaidCA

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
I20110818000739 CA Practitioner - Optometry 3173793684 Practice locations: Simi Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1420 E Los Angeles Ave
Suite B
Simi Valley, CA 93065-7805
Phone (805) 526-0842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8224TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1053461459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E LOS ANGELES AVE",
            "address_2": "SUITE B",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652848",
            "telephone_number": "805-526-0842",
            "fax_number": "805-526-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E LOS ANGELES AVE",
            "address_2": "SUITE B",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652848",
            "telephone_number": "805-526-0842",
            "fax_number": "805-526-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8224T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0082240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.