Active NPI
Colton Mark Heinrich, O.D.
- Optometrist
- Fullerton, CA
National Provider Identifier
1154701001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT15222
- Practice address
- 2575 Yorba Linda Blvd
Fullerton, CA 92831-1615 - Phone
- (714) 449-7401
- NPI assigned
- Jun 5, 2015
- Last updated
- Jun 5, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT15222 | CA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | OPT15222 | CA |
Addresses
Primary practice location
2575 Yorba Linda Blvd
Fullerton, CA 92831-1615
Mailing address
2575 Yorba Linda Blvd
Fullerton, CA 92831-1615
Phone (714) 449-7401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4314 Kemp Blvd
Wichita Falls, TX 76308-3716
Phone (940) 691-5645
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 26 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT15222 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarke Eyecare Center, LLP | Optometrist | Current | Accepting new patients |
Locations
4314 Kemp Blvd
Wichita Falls, TX 76308
Phone (940) 691-5645
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": "1433462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433462400000",
"number": "1154701001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2575 YORBA LINDA BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928311615",
"telephone_number": "714-449-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2575 YORBA LINDA BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928311615",
"telephone_number": "714-449-7401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEINRICH",
"first_name": "COLTON",
"middle_name": "MARK",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-05",
"last_updated": "2015-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT15222",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "OPT15222",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.