NPIMap

Organization Active NPI

Inland Eye Specialists a Medical Corp

  • Ophthalmology Physician
  • Hemet, CA
National Provider Identifier
1083622567
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
INLAND EYE SPECIALISTS A MEDICAL CORP
Practice address
3953 W Stetson Ave
Hemet, CA 92545-9687
Phone
(951) 652-4343
Fax
(951) 266-5302
NPI assigned
Aug 3, 2006
Last updated
Mar 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Authorized official

Name
Mr. George Neal
Title
Assistant Secretary
Phone
(844) 377-6468

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

3953 W Stetson Ave
Hemet, CA 92545-9687

Mailing address

PO Box 85426
Los Angeles, CA 90084-5426
Phone (951) 652-4343

Other identifiers 3

IdentifierTypeStateIssuer
GR0044190MedicaidCA
05C0001076OtherCA05C0001076 - CALIFORNIA - DME PTAN
GSD003100MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930055090 CA DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 3375447964 Practice locations: Hemet, CA
O20150831001748 CA Part B Supplier - Clinic/Group Practice 3375447964 Receives reassigned benefits from 25 practitioners
6 other NPIs on this enrollment
Practice locations: Fallbrook, CA; Temecula, CA; San Diego, CA; Murrieta, CA; Hemet, CA; Corona, CA; Beaumont, CA; Menifee, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Inland Eye Specialists9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1083622567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85426",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845426",
            "telephone_number": "951-652-4343",
            "fax_number": "951-266-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3953 W STETSON AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925459687",
            "telephone_number": "951-652-4343",
            "fax_number": "951-266-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EYE SPECIALISTS A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "844-377-6468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0044190",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "05C0001076 - CALIFORNIA - DME PTAN",
            "identifier": "05C0001076",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD003100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.