Individual provider Active NPI

Douglas Evan Levy, O.D.

  • Optometrist
  • Santa Monica, CA
National Provider Identifier
1184772782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9484T Issued in CA
Practice address
808 Wilshire Blvd Ste 140
Santa Monica, CA 90401-1896
Phone
(310) 393-3234
Fax
(310) 394-6294
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9484T CA Primary

Addresses

Primary practice location

808 Wilshire Blvd Ste 140
Santa Monica, CA 90401-1896

Mailing address

808 Wilshire Blvd Ste 140
Santa Monica, CA 90401-1896
Phone (310) 393-3234

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9484TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184772782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 WILSHIRE BLVD STE 140",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011896",
            "telephone_number": "310-393-3234",
            "fax_number": "310-394-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 WILSHIRE BLVD STE 140",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011896",
            "telephone_number": "310-393-3234",
            "fax_number": "310-394-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "DOUGLAS",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9484T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.