Individual provider Active NPI

Annie Hovakemian, OD

  • Optometrist
  • Moorpark, CA
National Provider Identifier
1063935880
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33686 Issued in CA
Practice address
4279 Tierra Rejada Rd
Moorpark, CA 93021-3775
Phone
(805) 222-2323
Fax
(805) 222-2333
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 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 OPT33686 CA Primary

Addresses

Primary practice location

4279 Tierra Rejada Rd
Moorpark, CA 93021-3775

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

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
I20180911002732 CA Practitioner - Optometry 8921358003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinicas del Camino Real IncGroup PAC ID 3173434396, 99 clinicians

Practice addresses (Care Compare)

4370 Eve Rd
Simi Valley, CA 93063-2323
Phone (805) 915-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33686CAMDChiropractor
OPT33686CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Dec 1, 2019 Accepting new patients
Clinicas del Camino Real Inc Current Accepting new patients
Clinicas del Camino Real Inc CurrentSince Dec 1, 2019 Accepting new patients
Clinicas del Camino Real Inc PastSince Nov 17, 2019 Accepting new patients
Clinicas del Camino Real Inc PastSince Nov 17, 2019 Accepting new patients

Locations

4279 Tierra Rejada Rd
Moorpark, CA 93021
Phone (805) 222-2323

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

Interoperability endpoints

  • Direct secure messaging: annie.hovakemian.p1@direct.clinicas.nextgenshare.com
  • Direct secure messaging: ahovakemian802608@direct.ochin.org

Organizations & group practices 5

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": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1063935880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 TIERRA REJADA RD",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930213775",
            "telephone_number": "805-222-2323",
            "fax_number": "805-222-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVAKEMIAN",
        "first_name": "ANNIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

Verify at the official NPI Registry.