Individual provider Active NPI

Joseph J Vansuch III, O.D.

  • Corneal and Contact Management Optometrist
  • Orange, CA
National Provider Identifier
1104807809
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
6373TPL Issued in CA
Practice address
128 E Katella Ave
Suite 100
Orange, CA 92867-4836
Phone
(714) 997-3535
Fax
(714) 771-4870
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 6373TPL CA Primary
Optometrist 152W00000X 6373TLG CA

Addresses

Primary practice location

128 E Katella Ave
Suite 100
Orange, CA 92867-4836

Mailing address

315 E Katella Ave
Orange, CA 92867-4860
Phone (714) 997-3535

Other identifiers 1

IdentifierTypeStateIssuer
330839978OtherCAVISION SERVICE PLAN

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
I20140306001757 CA Practitioner - Optometry 8325278625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6373TLGCAMDOptometrist
6373TPLCAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vansuch Optometric, Inc. Corneal and Contact Management CurrentSince Sep 18, 2013 Accepting new patients

Locations

128 E Katella Ave
Ste 100
Orange, CA 92867
Phone (714) 997-3535

315 E Katella Ave
Orange, CA 92867
Phone (714) 997-3535

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1104807809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E KATELLA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928674860",
            "telephone_number": "714-997-3535",
            "fax_number": "714-771-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E KATELLA AVE",
            "address_2": "SUITE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928674836",
            "telephone_number": "714-997-3535",
            "fax_number": "714-771-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSUCH",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "6373TPL",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6373TLG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN",
            "identifier": "330839978",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.