Individual provider Active NPI

Cory Bream, O.D.

  • Optometrist
  • Goleta, CA
National Provider Identifier
1053468439
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
101071T Issued in CA
Practice address
7095 Market Place Dr
Goleta, CA 93117-5905
Phone
(805) 562-1300
Fax
(805) 562-1301
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 101071T CA Primary

Addresses

Primary practice location

7095 Market Place Dr
Goleta, CA 93117-5905

Mailing address

3635 Santa Maria LN
Santa Barbara, CA 93105-3227
Phone (805) 562-1300

Other identifiers 2

IdentifierTypeStateIssuer
SD0101710OtherCAMEDICAL
33-0646638OtherCATAX ID

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
I20171129002756 CA Practitioner - Optometry 4880950310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goleta Valley Optometry IncGroup PAC ID 0648501858, 4 clinicians
Bream Optometry, Inc.Group PAC ID 4385073568, 4 clinicians

Practice addresses (Care Compare)

4850 Hollister Ave
Suite 102B
Santa Barbara, CA 93111-2800
Phone (805) 451-8180

7095 Market Place Dr
Goleta, CA 93117-5905
Phone (805) 562-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10171CAMDAddiction (Substance Use Disorder) Counselor
101071TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bream Optometry, Inc. Optometrist CurrentSince Feb 23, 2020 Accepting new patients
Cory Bream & Associates Optometrist Current Accepting new patients

Locations

2001 Ventura Blvd
Oxnard, CA 93036
Phone (805) 983-2377

7095 Market Place Dr
Santa Barbara, CA 93117
Phone (805) 562-1300

Organizations & group practices 3

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1053468439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 SANTA MARIA LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053227",
            "telephone_number": "805-562-1300",
            "fax_number": "805-562-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7095 MARKET PLACE DR",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931175905",
            "telephone_number": "805-562-1300",
            "fax_number": "805-562-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAM",
        "first_name": "CORY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "101071T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "SD0101710",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "33-0646638",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goleta, CA

Sources for this page

Verify at the official NPI Registry.