Dean A Ezaki, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

55207 Issued in CA

Practice address

776 West Napa Street
Sonoma, CA 95476

Phone

(707) 938-8116

Fax

(707) 938-8143

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

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)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1194796078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 WEST NAPA STREET",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "95476",
            "telephone_number": "707-938-8116",
            "fax_number": "707-938-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 WEST NAPA STREET",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "95476",
            "telephone_number": "707-938-8116",
            "fax_number": "707-938-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZAKI",
        "first_name": "DEAN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "55207",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "5520T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Marc Elmer, MD
• Ensign Sonoma LLC
• Joseph Ercolini, DC
• John Williams Evans, MD
• Eye Associates of Northern California Medical Group Inc.
• Maribel Fernandez, RN
• Ana G. Flaherty, M.A.
• Cressida A Forester, PSY. D.
• Julie Neal Forstadt, D.D.S.
• Marina Forte, NP

• Optometrist in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.

Verify at the official NPI Registry.