Individual provider Active NPI

Miguel Olmedo, OD

  • Optometrist
  • La Palma, CA
National Provider Identifier
1205558988
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35223 Issued in CA
Practice address
7862 Barbi LN
La Palma, CA 90623-1603
Phone
(562) 405-7309
NPI assigned
Sep 19, 2022
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35223 CA Primary

Addresses

Primary practice location

7862 Barbi LN
La Palma, CA 90623-1603

Mailing address

7862 Barbi LN
La Palma, CA 90623-1603
Phone (562) 405-7309

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
I20251219001302 CA Practitioner - Optometry 6406341155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7862 Barbi LN
La Palma, CA 90623-1603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35223CAMDOptometrist

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": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1205558988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7862 BARBI LN",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231603",
            "telephone_number": "562-405-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7862 BARBI LN",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231603",
            "telephone_number": "562-405-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMEDO",
        "first_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Palma, CA

Sources for this page

Verify at the official NPI Registry.