Active NPI
John Ikeda, O.D.
- Optometrist
- Buena Park, CA
National Provider Identifier
1215379268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14721
- Practice address
- 8751 Valley View St Ste a
Buena Park, CA 90620-3566 - Phone
- (714) 827-7191
- NPI assigned
- Jul 18, 2013
- 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 | 14721 | CA | Primary |
Addresses
Primary practice location
8751 Valley View St Ste a
Buena Park, CA 90620-3566
Mailing address
8751 Valley View St Ste a
Buena Park, CA 90620-3566
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 |
|---|---|---|---|---|
| I20130905000239 | CA | Practitioner - Optometry | 2365685690 | Practice locations: Buena Park, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Western University of Health Sciences College of Dental Med, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8751 Valley View St
Suite a
Buena Park, CA 90620-3566
Phone (714) 827-7191
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14721 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1215379268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8751 VALLEY VIEW ST STE A",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906203566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8751 VALLEY VIEW ST STE A",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906203566",
"telephone_number": "714-827-7191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IKEDA",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-18",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.