Individual provider Active NPI

Saul Cepeda, OD

  • Optometrist
  • Union City, CA
National Provider Identifier
1073573853
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8159T Issued in CA
Practice address
34640 Alvarado Niles Rd
Union City, CA 94587-4500
Phone
(510) 487-1335
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8159T CA Primary

Addresses

Primary practice location

34640 Alvarado Niles Rd
Union City, CA 94587-4500

Mailing address

34640 Alvarado Niles Rd
Union City, CA 94587-4500

Other identifiers 1

IdentifierTypeStateIssuer
SD0081590MedicaidCA

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
I20050203000403 CA Practitioner - Optometry 6709837073 Practice locations: San Jose, CA; Union City, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

34640 Alvarado Niles
Union City, CA 94587-4500
Phone (510) 487-1335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8159TCAMDOptometrist
8159CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1073573853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34640 ALVARADO NILES RD",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945874500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34640 ALVARADO NILES RD",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945874500",
            "telephone_number": "510-487-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEPEDA",
        "first_name": "SAUL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8159T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0081590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, CA

Sources for this page

Verify at the official NPI Registry.