Individual provider Active NPI

Dean E Fewtrell, OD

  • Optometrist
  • Salinas, CA
National Provider Identifier
1104912682
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT7793T Issued in CA
Practice address
311 Pajaro St
Salinas, CA 93901-3421
Phone
(831) 424-6201
Fax
(831) 757-4509
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 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 OPT7793T CA Primary

Addresses

Primary practice location

311 Pajaro St
Salinas, CA 93901-3421

Mailing address

311 Pajaro St
Salinas, CA 93901-3421
Phone (831) 424-6201

Other identifiers 1

IdentifierTypeStateIssuer
1841325834MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT7793TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Jess Estrada, a P O C Optometrist PastSince Mar 1, 2001 Accepting new patients

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1104912682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PAJARO ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013421",
            "telephone_number": "831-424-6201",
            "fax_number": "831-757-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PAJARO ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013421",
            "telephone_number": "831-424-6201",
            "fax_number": "831-757-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEWTRELL",
        "first_name": "DEAN",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT7793T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841325834",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.