Individual provider Active NPI

Shruti Pasari, O.D.

  • Optometrist
  • Newport Beach, CA
National Provider Identifier
1053549220
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11314T Issued in CA
Practice address
563 Newport Center Dr
Newport Beach, CA 92660-6937
Phone
(949) 301-8001
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11314T CA Primary

Addresses

Primary practice location

563 Newport Center Dr
Newport Beach, CA 92660-6937

Mailing address

17291 Irvine Blvd Ste 251
Tustin, CA 92780-2930
Phone (714) 731-4771

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
11314TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jan S Lukac MD Inc PastSince Jan 29, 2006 Accepting new patients

Organizations & group practices 1

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1053549220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17291 IRVINE BLVD STE 251",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802930",
            "telephone_number": "714-731-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 NEWPORT CENTER DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606937",
            "telephone_number": "949-301-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASARI",
        "first_name": "SHRUTI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11314T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.