Active NPI
Stephen Gerard Schroeder, OD
- Optometrist
- Lake Elsinore, CA
National Provider Identifier
1164584793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 8321T
- Practice address
- 25321 Railroad Canyon Dr.
#503
Lake Elsinore, CA 92532 - Phone
- (951) 244-1122
- Fax
- (951) 244-2777
- NPI assigned
- Dec 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8321T | CA | Primary |
Addresses
Primary practice location
25321 Railroad Canyon Dr.
#503
Lake Elsinore, CA 92532
Mailing address
31897 Birchwood Dr
Lake Elsinore, CA 92532-2629
Phone (951) 244-1122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8321T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michelle Cruz OD Inc | Optometrist | Past | Accepting new patients |
| Mary L. Demoss O.D. Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Canyon Lake, CA
- NPI 1457396871
-
- Optometrist
- Lake Elsinore, CA
- NPI 1033920939
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1164584793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31897 BIRCHWOOD DR",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925322629",
"telephone_number": "951-244-1122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25321 RAILROAD CANYON DR.",
"address_2": "#503",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "92532",
"telephone_number": "951-244-1122",
"fax_number": "951-244-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "STEPHEN",
"middle_name": "GERARD",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "8321T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.