Individual provider Active NPI

Andrawis Majdi Zada, OD

  • Student in an Organized Health Care Education/Training Program
  • Davis, CA
National Provider Identifier
1174265169
Registry record updated Apr 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
353 2ND St
Davis, CA 95616-4607
Phone
(530) 758-2122
NPI assigned
Apr 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

353 2ND St
Davis, CA 95616-4607

Mailing address

1144 Pebblewood Way
San Mateo, CA 94403-4914
Phone (650) 274-1709

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
I20220922001213 CA Practitioner - Optometry 1759766009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Helmus OptometryGroup PAC ID 9032427927, 5 clinicians

Practice addresses (Care Compare)

353 2ND St
Davis, CA 95616-4607
Phone (530) 758-2122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tedder Optometric Corporation, PC CurrentSince Sep 26, 2023 Accepting new patients
Hansra Optometric Corporation CurrentSince Sep 26, 2023 Accepting new patients
Helmus Optometry CurrentSince Aug 30, 2022 Accepting new patients
Helmus Optometry PastSince Apr 17, 2022 Accepting new patients

Locations

353 2nd St
Davis, CA 95616
Phone (530) 758-2122

825 E Bidwell St
Ste 100
Folsom, CA 95630
Phone (279) 202-1202

23625 El Toro Rd
Ste E
Lake Forest, CA 92630
Phone (949) 227-2524

1208 Galleria Blvd
Ste 160
Roseville, CA 95678
Phone (279) 214-0170

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649548800000",
    "number": "1174265169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 PEBBLEWOOD WAY",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034914",
            "telephone_number": "650-274-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 2ND ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164607",
            "telephone_number": "530-758-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADA",
        "first_name": "ANDRAWIS",
        "middle_name": "MAJDI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-10",
        "last_updated": "2022-04-10",
        "certification_date": "2022-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.