Organization Active NPI

Dr. Margarette Recalde, OD, Inc.

Doing business as Lifetime Optometric

  • Optometrist
  • Fresno, CA
National Provider Identifier
1134643265
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR. MARGARETTE RECALDE, OD, INC.
Doing business as
Lifetime Optometric
Practice address
1111 E. Herndon Ave. Ste 101
Fresno, CA 93720-3100
Phone
(559) 432-2200
Fax
(559) 432-2203
NPI assigned
Jul 31, 2017
Last updated
Aug 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Dr. Margarette RecaldeNPI 1972695500
Title
Owner
Phone
(559) 432-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CA Primary

Addresses

Primary practice location

1111 E. Herndon Ave. Ste 101
Fresno, CA 93720-3100

Mailing address

1111 E Herndon Ave Ste 101
Fresno, CA 93720-3100
Phone (559) 432-2200

Other identifiers 2

IdentifierTypeStateIssuer
SD0114360OtherCAMEDICARE
U97638OtherCAMEDICARE UPIN

Other names 1

  • Lifetime Optometric Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170906000735 CA Part B Supplier - Clinic/Group Practice 4385917814 Receives reassigned benefits from 2 practitioners
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1134643265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203100",
            "telephone_number": "559-432-2200",
            "fax_number": "559-432-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E. HERNDON AVE. STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203100",
            "telephone_number": "559-432-2200",
            "fax_number": "559-432-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARGARETTE RECALDE, OD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "RECALDE",
        "authorized_official_first_name": "MARGARETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-432-2200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SD0114360",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN",
            "identifier": "U97638",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Optometric",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifetime Optometric",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.