NPIMap

Organization Active NPI

Studio Optics Optometric Group, Inc.

  • Ophthalmology Physician
  • Santa Clara, CA
National Provider Identifier
1083617302
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
COR989 Issued in CA
Legal business name
STUDIO OPTICS OPTOMETRIC GROUP, INC.
Practice address
3159 Mission College Blvd
Santa Clara, CA 95054-1832
Phone
(408) 492-1111
Fax
(408) 492-9255
NPI assigned
May 31, 2005
Last updated
Jan 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Authorized official

Name
Dr. Moshe Mendelson, O.D.
Title
President
Phone
(408) 492-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X COR989 CA Primary

Addresses

Primary practice location

3159 Mission College Blvd
Santa Clara, CA 95054-1832

Mailing address

3159 Mission College Blvd
Santa Clara, CA 95054-1832
Phone (408) 492-1111

Other identifiers 1

IdentifierTypeStateIssuer
5081750001OtherCAMEDICARE - DMERC

National Provider Directory

National Provider Directory

Locations

1010 W Fremont Ave
Sunnyvale, CA 94087
Phone (408) 739-6200

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1083617302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3159 MISSION COLLEGE BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541832",
            "telephone_number": "408-492-1111",
            "fax_number": "408-492-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3159 MISSION COLLEGE BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541832",
            "telephone_number": "408-492-1111",
            "fax_number": "408-492-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUDIO OPTICS OPTOMETRIC GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "MENDELSON",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-492-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "COR989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - DMERC",
            "identifier": "5081750001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.