Organization Active NPI

Clearview Eye & Laser Medical Center a Professional Corporation

  • Ophthalmology Physician
  • San Diego, CA
National Provider Identifier
1164529160
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G57688 Issued in CA
Legal business name
CLEARVIEW EYE & LASER MEDICAL CENTER A PROFESSIONAL CORPORATION
Practice address
6255 Lusk Blvd
San Diego, CA 92121-3763
Phone
(858) 452-3937
Fax
(858) 452-3933
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Dr. Sandy T Feldman, MDNPI 1821284092
Title
President
Phone
(858) 452-3937

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G57688 CA Primary

Addresses

Primary practice location

6255 Lusk Blvd
San Diego, CA 92121-3763

Mailing address

PO Box 2530
Del Mar, CA 92014-1830
Phone (858) 452-3937

Other identifiers 1

IdentifierTypeStateIssuer
LICENSEOtherCAG57688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000875 CA Part B Supplier - Clinic/Group Practice 8729022793 Receives reassigned benefits from 5 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

9833 Pacific Heights Blvd
Ste J
San Diego, CA 92121
Phone (858) 452-3937

6255 Lusk Blvd
San Diego, CA 92121
Phone (858) 452-3937

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1164529160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2530",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141830",
            "telephone_number": "858-452-3937",
            "fax_number": "858-452-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 LUSK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213763",
            "telephone_number": "858-452-3937",
            "fax_number": "858-452-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARVIEW EYE & LASER MEDICAL CENTER A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "FELDMAN",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-452-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G57688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "G57688",
            "identifier": "LICENSE",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.