Active NPI
Burton Charles Blaurock, O.D.
- Optometrist
- Rancho Mirage, CA
National Provider Identifier
1194719302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5996T
- Practice address
- 42452 Bob Hope Dr
Suite 1
Rancho Mirage, CA 92270-4470 - Phone
- (760) 340-4524
- Fax
- (760) 340-4796
- NPI assigned
- Sep 1, 2005
- 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 | 5996T | CA | Primary |
Addresses
Primary practice location
42452 Bob Hope Dr
Suite 1
Rancho Mirage, CA 92270-4470
Mailing address
42452 Bob Hope Dr
Suite 1
Rancho Mirage, CA 92270-4470
Phone (760) 340-4524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0059960 | Medicaid | CA |
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 |
|---|---|---|---|---|
| I20100910000799 | CA | Practitioner - Optometry | 6406971688 | Practice locations: Rancho Mirage, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
42452 Bob Hope Dr
Suite a
Rancho Mirage, CA 92270-4435
Phone (760) 340-4524
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5996T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burton C Blaurock OD | 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, 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": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476316800000",
"number": "1194719302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42452 BOB HOPE DR",
"address_2": "SUITE 1",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922704470",
"telephone_number": "760-340-4524",
"fax_number": "760-340-4796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42452 BOB HOPE DR",
"address_2": "SUITE 1",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922704470",
"telephone_number": "760-340-4524",
"fax_number": "760-340-4796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAUROCK",
"first_name": "BURTON",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2016-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5996T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0059960",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mirage, CA
- Paul Alexander Biskar, M.D.
- James Bivins, NURSE PRACTITIONER
- Leland Paul Black, MD
- Lawrence Burnett Blackmon, D.D.S.
- Kenneth Blake, H.I.S.
- BLC Mirage Inn, L.P. (Brookdale Mirage Inn)
- Beverly Belle Blessing, FNP, PHD
- Jonathan William Blevins, M.D.
- Block Counseling, Family & Child Therapy Inc.
- Blood & Cancer Genetics Institute
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.