Individual provider Active NPI

Ami T Patel, O.D.

  • Optometrist
  • Chino Hills, CA
National Provider Identifier
1194898569
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9067T Issued in CA
Practice address
3233 Grand Ave Ste M
Chino Hills, CA 91709-1489
Phone
(909) 591-2034
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9067T CA Primary

Addresses

Primary practice location

3233 Grand Ave Ste M
Chino Hills, CA 91709-1489

Mailing address

3233 Grand Ave Ste M
Chino Hills, CA 91709-1489
Phone (909) 591-2034

Other identifiers 1

IdentifierTypeStateIssuer
SD009067MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220504000335 CA Practitioner - Optometry 5597849935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suneet K Gupta IncGroup PAC ID 4688701105, 3 clinicians

Practice addresses (Care Compare)

3233 Grand Ave
Suite M
Chino Hills, CA 91709-1489
Phone (909) 591-2034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9067TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Suneet K Gupta Inc Optometrist CurrentSince Mar 7, 2022 Accepting new patients
Dr Ami Patel, Optometrist Optometrist PastSince Feb 4, 2008 Accepting new patients

Locations

3233 Grand Ave
Ste M
Chino Hills, CA 91709
Phone (909) 591-2034

Organizations & group practices 2

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1194898569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 GRAND AVE STE M",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091489",
            "telephone_number": "909-591-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 GRAND AVE STE M",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091489",
            "telephone_number": "909-591-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMI",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9067T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD009067",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.