Individual provider Active NPI

Raymond Noboru Umeda, O.D.

  • Optometrist
  • Campbell, CA
National Provider Identifier
1104895432
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07375 T Issued in CA
Practice address
290 W Hamilton Ave
Campbell, CA 95008-0507
Phone
(408) 374-7000
Fax
(408) 374-7211
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 07375 T CA Primary

Addresses

Primary practice location

290 W Hamilton Ave
Campbell, CA 95008-0507

Mailing address

290 W Hamilton Ave
Campbell, CA 95008-0507
Phone (408) 374-7000

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
I20040304001378 CA Practitioner - Optometry 4284522962 Practice locations: Campbell, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07375 TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1104895432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 W HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080507",
            "telephone_number": "408-374-7000",
            "fax_number": "408-374-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 W HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080507",
            "telephone_number": "408-374-7000",
            "fax_number": "408-374-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMEDA",
        "first_name": "RAYMOND",
        "middle_name": "NOBORU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "07375 T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.