Organization Active NPI

Children's Eye Care of Los Gatos, Inc., a Professional Corp.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Los Gatos, CA
National Provider Identifier
1174937999
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
Legal business name
CHILDREN'S EYE CARE OF LOS GATOS, INC., A PROFESSIONAL CORP.
Practice address
250 Almendra Ave
Los Gatos, CA 95030-7211
Phone
(408) 399-9009
Fax
(408) 399-9073
NPI assigned
Jun 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
Anita Breckenridge, M.D.NPI 1396841037
Title
Managing Physician
Phone
(408) 399-9009

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
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0110X Primary

Addresses

Primary practice location

250 Almendra Ave
Los Gatos, CA 95030-7211

Mailing address

250 Almendra Ave
Los Gatos, CA 95030-7211
Phone (408) 399-9009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150918002358 CA Part B Supplier - Clinic/Group Practice 7416264726 Receives reassigned benefits from 1 practitioner
Practice locations: Los Gatos, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1174937999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 ALMENDRA AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950307211",
            "telephone_number": "408-399-9009",
            "fax_number": "408-399-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ALMENDRA AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950307211",
            "telephone_number": "408-399-9009",
            "fax_number": "408-399-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S EYE CARE OF LOS GATOS, INC., A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "BRECKENRIDGE",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "408-399-9009",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.