Individual provider Active NPI

Clara Yadira Damian-Santana, O.D.

  • Optometrist
  • Santa Ana, CA
National Provider Identifier
1215224241
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14170 Issued in CA
Practice address
2860 S Bristol St
Suite D
Santa Ana, CA 92704-6200
Phone
(714) 540-3993
Fax
(844) 231-8874
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14170 CA Primary

Addresses

Primary practice location

2860 S Bristol St
Suite D
Santa Ana, CA 92704-6200

Mailing address

2860 S Bristol St
Suite D
Santa Ana, CA 92704-6200
Phone (714) 540-3993

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
I20140303000383 CA Practitioner - Optometry 2567691819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14170CAMDProfessional Counselor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1215224241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S BRISTOL ST",
            "address_2": "SUITE D",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046200",
            "telephone_number": "714-540-3993",
            "fax_number": "844-231-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S BRISTOL ST",
            "address_2": "SUITE D",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927046200",
            "telephone_number": "714-540-3993",
            "fax_number": "844-231-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIAN-SANTANA",
        "first_name": "CLARA",
        "middle_name": "YADIRA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.