Organization Active NPI

Advanced Artificial Eyes

  • Ocularist
  • Woodland Hills, CA
National Provider Identifier
1053775502
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Legal business name
ADVANCED ARTIFICIAL EYES
Practice address
21112 Ventura Blvd
Woodland Hills, CA 91364-2103
Phone
(818) 758-1666
Fax
(818) 758-1786
NPI assigned
Apr 11, 2016
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
John Matthew Stolpe, B.CO. ,B.A.D.O.NPI 1124345756
Title
Board Certified Ocularist, Board Ap
Phone
(818) 758-1666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X Primary
Prosthetist 224P00000X
Anaplastologist 229N00000X

Addresses

Primary practice location

21112 Ventura Blvd
Woodland Hills, CA 91364-2103

Mailing address

21112 Ventura Blvd
Woodland Hills, CA 91364-2103
Phone (818) 758-1666

Other practice location 1

18455 Burbank Blvd Suite 202
Tarzana, CA 91356-2802
Phone (818) 758-1666

Other identifiers 2

IdentifierTypeStateIssuer
6419480001MedicaidCA
6419480001OtherCAMEDICARE PTAN

Other names 1

  • John Stolpe, B.C.O. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160909000748 CA DME Supplier - OcularistDME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 4688960180 Practice locations: Woodland Hills, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Advanced Artificial Eyes, Inc21112 Ventura Blvd, Woodland Hills, CA 91364-2103(818) 758-1666 Facial Prostheses|Ocular Prostheses|Somatic Prostheses Does not accept assignmentParticipating since Sep 9, 2016

National Provider Directory

National Provider Directory

Locations

18455 Burbank Blvd
Ste 202
Tarzana, CA 91356
Phone (310) 278-1839

21112 Ventura Blvd
Woodland Hills, CA 91364
Phone (818) 758-1666

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1053775502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21112 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642103",
            "telephone_number": "818-758-1666",
            "fax_number": "818-758-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21112 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642103",
            "telephone_number": "818-758-1666",
            "fax_number": "818-758-1786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18455 Burbank Blvd Suite 202",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913562802",
            "country_code": "US",
            "telephone_number": "818-758-1666",
            "fax_number": "818-758-1786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED ARTIFICIAL EYES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "STOLPE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "BOARD CERTIFIED OCULARIST, BOARD AP",
        "authorized_official_telephone_number": "818-758-1666",
        "authorized_official_credential": "B.CO. ,B.A.D.O."
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "229N00000X",
            "taxonomy_group": "",
            "desc": "Anaplastologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6419480001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6419480001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John Stolpe, B.C.O.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.