Individual provider Active NPI

Alicia Michelle Harrison-Sicre, O.D.

  • Optometrist
  • Laguna Beach, CA
National Provider Identifier
1124247523
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11495TLG Issued in CA
Practice address
1100 S Coast Hwy
Ste 201
Laguna Beach, CA 92651-2968
Phone
(949) 497-1769
Fax
(949) 497-2808
NPI assigned
Apr 24, 2007
Last updated
Jun 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT11495TPL CA
Optometrist 152W00000X 11495TLG CA Primary

Addresses

Primary practice location

1100 S Coast Hwy
Ste 201
Laguna Beach, CA 92651-2968

Mailing address

1100 S Coast Hwy
Ste 201
Laguna Beach, CA 92651-2968
Phone (949) 497-1769

Other names 1

  • Alicia Michelle Harrison Professional name

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
I20090820000464 CA Practitioner - Optometry 5294889523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1100 S Coast Hwy
Suite 201
Laguna Beach, CA 92651-2969
Phone (949) 497-1769

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11495TLGCAMDOptometrist
OPT11495TPLCAMDOptometrist
11495CAMDAcupuncturist

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, 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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1124247523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY",
            "address_2": "STE 201",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512968",
            "telephone_number": "949-497-1769",
            "fax_number": "949-497-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S COAST HWY",
            "address_2": "STE 201",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512968",
            "telephone_number": "949-497-1769",
            "fax_number": "949-497-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON-SICRE",
        "first_name": "ALICIA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT11495TPL",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11495TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "HARRISON",
            "middle_name": "MICHELLE",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Laguna Beach, CA

Sources for this page

Verify at the official NPI Registry.