NPIMap

Individual provider Active NPI

Kody Michael Cowell

  • Optometrist
  • Paso Robles, CA
National Provider Identifier
1083337489
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35292 Issued in CA
Practice address
2800 Riverside Ave
Paso Robles, CA 93446-1311
Phone
(805) 238-7250
Fax
(805) 238-0165
NPI assigned
Sep 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35292 CA Primary

Addresses

Primary practice location

2800 Riverside Ave
Paso Robles, CA 93446-1311

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107003208 CA Practitioner - Optometry 8527435361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Central Coast IncGroup PAC ID 7416868120, 74 clinicians

Practice addresses (Care Compare)

2800 Riverside Ave
Suite 101
Paso Robles, CA 93446-1312
Phone (805) 929-3211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT35292CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jul 8, 2024 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jul 8, 2024 Accepting new patients
United Health Centers of the San Joaquin Valley PastSince Sep 1, 2022 Accepting new patients
Community Health Center of the Central Coast Inc Past Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

425 W Central Ave
Lompoc, CA 93436
Phone (805) 736-2020

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2800 Riverside Ave
Paso Robles, CA 93446
Phone (805) 238-7250

2800 Riverside Ave
Ste 101
Paso Robles, CA 93446
Phone (805) 238-7250

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

Interoperability endpoints

  • Direct secure messaging: kody.cowell.1@17363.direct.athenahealth.com

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1083337489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 RIVERSIDE AVE",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934461311",
            "telephone_number": "805-238-7250",
            "fax_number": "805-238-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWELL",
        "first_name": "KODY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

Verify at the official NPI Registry.