Individual provider Active NPI

Steven Roy Kleen, O.D.

  • Optometrist
  • Redlands, CA
National Provider Identifier
1063497741
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT6721TPL Issued in CA
Practice address
2050 W Redlands Blvd
Redlands, CA 92373-6228
Phone
(909) 792-3457
Fax
(909) 307-1863
NPI assigned
Dec 14, 2005
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT6721TPL CA Primary

Addresses

Primary practice location

2050 W Redlands Blvd
Redlands, CA 92373-6228

Mailing address

2745 Moliere CT
Henderson, NV 89044-0316
Phone (909) 792-3457

Other practice location 1

4001 Hallmark Pkwy
San Bernardino, CA 92407-1876
Phone (909) 887-1881

Other practice location 2

58501 29 Palms Hwy
Yucca Valley, CA 92284-5765
Phone (760) 365-7350

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
I20081205000476 CA Practitioner - Optometry 9638066582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2050 W Redlands Blvd
Redlands, CA 92373-6228
Phone (909) 792-3457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT6721TPLCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carpinteria Eye Care Center of Optometry Optometrist CurrentSince Jan 24, 2018 Accepting new patients

Locations

1013 Casitas Pass Rd
Carpinteria, CA 93013
Phone (805) 451-0961

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1063497741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 MOLIERE CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890440316",
            "telephone_number": "909-792-3457",
            "fax_number": "909-307-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736228",
            "telephone_number": "909-792-3457",
            "fax_number": "909-307-1863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Hallmark Pkwy",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924071876",
            "country_code": "US",
            "telephone_number": "909-887-1881",
            "fax_number": "909-887-8557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58501 29 Palms Hwy",
            "address_purpose": "LOCATION",
            "city": "Yucca Valley",
            "state": "CA",
            "postal_code": "922845765",
            "country_code": "US",
            "telephone_number": "760-365-7350",
            "fax_number": "760-228-2814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEEN",
        "first_name": "STEVEN",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT6721TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.