Individual provider Active NPI

Faith Enfield, O.D.

  • Optometrist
  • San Bernardino, CA
National Provider Identifier
1104139104
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13942 Issued in CA
Practice address
2150 N Waterman Ave Ste 201
San Bernardino, CA 92404-4811
Phone
(805) 801-9967
NPI assigned
Jul 19, 2010
Last updated
Mar 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13942 CA Primary

Addresses

Primary practice location

2150 N Waterman Ave Ste 201
San Bernardino, CA 92404-4811

Mailing address

2150 N Waterman Ave Ste 201
San Bernardino, CA 92404-4811
Phone (805) 801-9967

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
I20140218000129 CA Practitioner - Optometry 8527297506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2150 N Waterman Ave
Suite 201
San Bernardino, CA 92404-4811
Phone (909) 881-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arthur Friedman OD a Professional Optometric Corporation Optometrist CurrentSince Oct 16, 2013 Accepting new patients
Arthur Friedman OD Apoc Optometrist Past Accepting new patients

Locations

2150 N Waterman Ave
Ste 201
Sn Bernrdno, CA 92404
Phone (909) 717-9636

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1104139104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE STE 201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "805-801-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE STE 201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "805-801-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENFIELD",
        "first_name": "FAITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.