Active NPI
Jilber Fouladian, O.D.
- Optometrist
- Los Angeles, CA
National Provider Identifier
1174669873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12294T
- Practice address
- 1312 Westwood Blvd
Los Angeles, CA 90024-4902 - Phone
- (310) 234-8900
- Fax
- (310) 388-0188
- NPI assigned
- Jan 29, 2007
- Last updated
- Jun 22, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 12294T | CA | Primary |
Addresses
Primary practice location
1312 Westwood Blvd
Los Angeles, CA 90024-4902
Mailing address
1312 Westwood Blvd
Los Angeles, CA 90024-4902
Phone (310) 709-4373
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040130001075 | CA | Practitioner - Optometry | 7911800404 | Practice locations: Los Angeles, CA; Montrose, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1312 Westwood Blvd
Los Angeles, CA 90024-4902
Phone (310) 234-8900
2490 Honolulu Ave
Suite 140B
Montrose, CA 91020-1800
Phone (818) 330-7555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12294T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | 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, 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": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498089600000",
"number": "1174669873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 WESTWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900244902",
"telephone_number": "310-709-4373",
"fax_number": "310-388-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 WESTWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900244902",
"telephone_number": "310-234-8900",
"fax_number": "310-388-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOULADIAN",
"first_name": "JILBER",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2017-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12294T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.