Individual provider Active NPI

Peter Lawrence Miller, O.D.

  • Optometrist
  • Pleasanton, CA
National Provider Identifier
1154397719
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9882T Issued in CA
Practice address
1400 Santa Rita Rd
Suite B
Pleasanton, CA 94566-5666
Phone
(925) 846-4364
Fax
(925) 846-7825
NPI assigned
Feb 24, 2006
Last updated
Apr 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9882T CA Primary

Addresses

Primary practice location

1400 Santa Rita Rd
Suite B
Pleasanton, CA 94566-5666

Mailing address

1400 Santa Rita Rd
Suite B
Pleasanton, CA 94566-5666
Phone (925) 846-4364

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
I20081223000663 CA Practitioner - Optometry 5890857197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pleasanton Optometry, Inc.Group PAC ID 2163582297, 2 clinicians

Practice addresses (Care Compare)

1400 Santa Rita Rd
Suite F
Pleasanton, CA 94566-5663
Phone (925) 846-4364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9882TCAMDOptometrist
9882CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasanton Optometry, Inc. Optometrist CurrentSince Oct 12, 2001 Accepting new patients

Locations

1400 Santa Rita Rd
Ste B
Pleasanton, CA 94566
Phone (925) 846-4364

1400 Santa Rita Rd
Ste F
Pleasanton, CA 94566
Phone (925) 600-0078

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1154397719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SANTA RITA RD",
            "address_2": "SUITE B",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945665666",
            "telephone_number": "925-846-4364",
            "fax_number": "925-846-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SANTA RITA RD",
            "address_2": "SUITE B",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945665666",
            "telephone_number": "925-846-4364",
            "fax_number": "925-846-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PETER",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9882T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.