Benica Eyvazzadeh, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT10222 Issued in CA

Practice address

351 Rolling Oaks Dr
102
Thousand Oaks, CA 91361-1275

Phone

(805) 497-3744

Fax

(805) 497-1663

NPI assigned

Jun 12, 2006

Last updated

Jul 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Illinois College of Optometry at Chicago, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cse Medical Group Inc.Group PAC ID 4082682034, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.11 of 100Reported as group

Quality

94.93

Improvement activities

40

Cost

77.13

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cse Medical Group Inc.

  dba Conejo Simi Eye Medical Group

  • Ophthalmology Physician
  • Thousand Oaks, CA
  • NPI 1215979844
  Medicare reassignment Care Compare group NPD
• Coastal Eye Specialists Medical Group Inc

  • Optometrist
  • Oxnard, CA
  • NPI 1891873139
  NPD (past)
• Miramar Lynn Medical Group Inc

  dba Lynn Eye Medical Group

  • Ophthalmology Physician
  • Thousand Oaks, CA
  • NPI 1043631419
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1225070600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 ROLLING OAKS DR",
            "address_2": "102",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611275",
            "telephone_number": "805-497-3744",
            "fax_number": "805-497-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 ROLLING OAKS DR",
            "address_2": "102",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611275",
            "telephone_number": "805-497-3744",
            "fax_number": "805-497-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYVAZZADEH",
        "first_name": "BENICA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT10222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "WOP10222G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Erica Everett, PA-C
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• Ez Sleep Technologies
• Ez Sleep, LLC
• Manijeh Ezatvar, RPT
• Navid Ezra, M.D.
• F Esfandiari Dental Corporation

• Optometrist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.