San Diego Eyelid Specialists, Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A105824 Issued in CA

Legal business name

SAN DIEGO EYELID SPECIALISTS, INC.

Practice address

477 N El Camino Real
A304
Encinitas, CA 92024-1328

Phone

(858) 432-2700

NPI assigned

Jan 26, 2016

Organization subpart

No

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

Authorized official

Name

Srinivas Iyengar, M.D.NPI 1104030055

Title

Managing Partner

Phone

(760) 456-9462

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Srinivas Iyengar, MD

  • Ophthalmology Physician
  • Encinitas, CA
  • NPI 1104030055
  Medicare reassignment Authorized official
• George Villatoro, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Houston, TX
  • NPI 1306473541

  CA, Ophthalmology

  Medicare reassignment NPD

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1124485784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "A304",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "A304",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328",
            "telephone_number": "858-432-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO EYELID SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "IYENGAR",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "760-456-9462",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A105824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samina Makani, M.D.
• Marianna Samuels, O.D.
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• San Diego Hebrew Homes
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• San Diego Home Health Care Agency,LLC

• Ophthalmology Physician in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.