Individual provider Active NPI

Douglas Stefanyk, O. D.

  • Vision Therapy Optometrist
  • Bakersfield, CA
National Provider Identifier
1184724924
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
13155 Issued in CA
Practice address
5300 Lennox Ave
Suite #101
Bakersfield, CA 93309-1662
Phone
(661) 869-2010
Fax
(661) 869-2708
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13155 CA
Vision Therapy Optometrist 152WV0400X 13155 CA Primary

Addresses

Primary practice location

5300 Lennox Ave
Suite #101
Bakersfield, CA 93309-1662

Mailing address

8201 Camino Media
#202
Bakersfield, CA 93311-2002

Other identifiers 1

IdentifierTypeStateIssuer
SD0131550MedicaidCA

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

LicenseStateTypeSpecialty
13155CAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Penelope S. Suter, O.D., an Optometric Professional Corporation Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1184724924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 CAMINO MEDIA",
            "address_2": "#202",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933112002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 LENNOX AVE",
            "address_2": "SUITE #101",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933091662",
            "telephone_number": "661-869-2010",
            "fax_number": "661-869-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANYK",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13155",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "13155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0131550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.