Evan Goldman, OD
Individual provider Active NPI Optometrist · Laguna Woods, CA
NPI 1154975738 · NPPES record last updated Sep 25, 2021
Key facts
- NPI
- 1154975738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 34302TLG (CA)
- Practice address
- 24100 El Toro Rd Ste C
Laguna Woods, CA 92637-3129 - Phone
- (949) 586-8980
- NPI assigned
- Jul 31, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Michael Goldman O.D.Incorporated
Practice addresses (Care Compare)
24100 El Toro Rd
Suite C
Laguna Woods, CA 92637-3129
Phone (949) 586-8980
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191111001670 | CA | Practitioner - Optometry | 2860824943 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34302TLG | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Eyecare Professional Optometric Group | Optometrist | Current |
Accepting new patients |
| Michael Goldman O.D.Incorporated | Optometrist | Current |
Accepting new patients |
Locations
330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890
1055 Foothill Blvd
La Canada, CA 91011
24100 El Toro Rd
Ste C
Laguna Woods, CA 92637
Phone (949) 586-8980
6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 34302TLG | CA | Yes |
Addresses
Primary practice location
24100 El Toro Rd Ste C
Laguna Woods, CA 92637-3129
Mailing address
41 Crestview Dr
Rancho Santa Margarita, CA 92688-5559
Phone (949) 922-7731
Other providers in Laguna Woods, CA
- Alec Ryan Garcia
- Larry Marc Gersten
- Navid Geula
- Faranak Chloe Ghazi
- Bruce Glover
- Michael Mark Goldman
- Ruth L. Goldman
- David Jr Gonzalez
- Scott Michael Graham
- Susan K Grenz
All providers in Laguna Woods, CA · Optometrist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.