Individual provider Active NPI

Lassa J Frank, O.D.

  • Optometrist
  • San Anselmo, CA
National Provider Identifier
1235190208
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8464TPL Issued in CA
Practice address
1604 Sir Francis Drake Blvd
San Anselmo, CA 94960-1845
Phone
(415) 453-8906
Fax
(415) 453-0156
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 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 8464TPL CA Primary

Addresses

Primary practice location

1604 Sir Francis Drake Blvd
San Anselmo, CA 94960-1845

Mailing address

1604 Sir Francis Drake Blvd
San Anselmo, CA 94960-1845
Phone (415) 453-8906

Other identifiers 9

IdentifierTypeStateIssuer
5091080001OtherCADMERC CIGNA SUPPLIER #
680226455OtherCAVISION SERVICE PLAN ID#
8464TPLOtherCALICENSE NUMBER
P00260245OtherCAMEDICARE RAILROAD PIN
0003748569OtherCACALIFORNIA EMPLOYER ID
680226455OtherCABLUE CROSS ID NUMBER
680226455OtherCAUNITEDHEALTHCARE ID #
942846602OtherCAFEDERAL ID NUMBER
SD0084640OtherCABLUE SHIELD PIN

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
I20040112000425 CA Practitioner - Optometry 1355241654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1604 Sir Francis Drake Blvd
San Anselmo, CA 94960-1845
Phone (415) 456-8906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8464TPLCAMDOptometrist
8464CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lassa J. Frank, OD, Inc Optometrist CurrentSince Feb 15, 2014 Accepting new patients

Locations

1604 Sir Francis Drk Blvd
San Anselmo, CA 94960
Phone (415) 453-8906

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235190208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 SIR FRANCIS DRAKE BLVD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601845",
            "telephone_number": "415-453-8906",
            "fax_number": "415-453-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 SIR FRANCIS DRAKE BLVD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601845",
            "telephone_number": "415-453-8906",
            "fax_number": "415-453-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANK",
        "first_name": "LASSA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8464TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC CIGNA SUPPLIER #",
            "identifier": "5091080001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN ID#",
            "identifier": "680226455",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "8464TPL",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PIN",
            "identifier": "P00260245",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA EMPLOYER ID",
            "identifier": "0003748569",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID NUMBER",
            "identifier": "680226455",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE ID #",
            "identifier": "680226455",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL ID NUMBER",
            "identifier": "942846602",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "SD0084640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

Verify at the official NPI Registry.