Individual provider Active NPI

Brian Edward NG, OD

  • Optometrist
  • Santa Barbara, CA
National Provider Identifier
1063935591
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33770TLG Issued in CA
Practice address
317 W Pueblo St
Santa Barbara, CA 93105
Phone
(805) 681-8980
NPI assigned
Jul 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33770TLG CA Primary

Addresses

Primary practice location

317 W Pueblo St
Santa Barbara, CA 93105

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1872

Other practice location 1

125 E Gonzales Rd
Oxnard, CA 93036-8259
Phone (805) 485-4854

Other practice location 2

4151 Foothill Rd
Santa Barbara, CA 93110-1110
Phone (805) 681-8980

Other identifiers 1

IdentifierTypeStateIssuer
OPT33770-TLGOtherCAMEDICAL LICENSE

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
I20180316002262 CA Practitioner - Optometry 2769744408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

317 W Pueblo St
Santa Barbara, CA 93105-4310
Phone (805) 681-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33770CAMDChiropractor
33770TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Sep 10, 2019 Accepting new patients
Sansum Clinic CurrentSince Sep 10, 2019 Accepting new patients
Silver Strand Optometry Corp Optometrist PastSince Feb 21, 2018 Accepting new patients
Robert F. Collins Optometrist PastSince Feb 21, 2018 Accepting new patients
Sansum Clinic Past Accepting new patients

Locations

4151 Foothill Rd
Santa Barbara, CA 93110
Phone (805) 681-1760

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

3916 State St
Ste 1C
Santa Barbara, CA 93105
Phone (805) 681-8980

317 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 681-7500

Organizations & group practices 6

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1063935591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-681-8980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 E Gonzales Rd",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930368259",
            "country_code": "US",
            "telephone_number": "805-485-4854",
            "fax_number": "805-485-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4151 Foothill Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931101110",
            "country_code": "US",
            "telephone_number": "805-681-8980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33770TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OPT33770-TLG",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.