Individual provider Active NPI

Ben C Palmer, O.D.

  • Optometrist
  • Nipomo, CA
National Provider Identifier
1235463944
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13794 Issued in CA
Practice address
150 S Mary Ave Ste 4
Nipomo, CA 93444-7821
Phone
(805) 929-1982
Fax
(805) 929-5052
NPI assigned
Sep 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 100188 ID
Optometrist 152W00000X 13794 CA Primary

Addresses

Primary practice location

150 S Mary Ave Ste 4
Nipomo, CA 93444-7821

Mailing address

150 S Mary Ave Ste 4
Nipomo, CA 93444-7821
Phone (805) 929-1982

Other identifiers 4

IdentifierTypeStateIssuer
1235463944MedicaidCA
FI860AOtherCAGROUP MEDICARE PTAN
1346539095OtherCATYPE II (GROUP) NPI
1235463944OtherCATYPE I (INDIVIDUAL) NPI

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
I20100626000494 CA Practitioner - Optometry 6608907167 Reassigns benefits to 1 organization
Practice locations: Nipomo, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 Mary Ave
Nipomo, CA 93444-5660

Merit-based Incentive Payment System (MIPS)

Final score
88.48 of 100Reported as individual
Quality
76.97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100188IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Palmer, O.D. a Professional Optometric Corporation Optometrist CurrentSince Apr 4, 2011 Accepting new patients
Nipomo Optometry Inc Optometrist Past Accepting new patients

Locations

150 Mary Ave
Ste 45
Nipomo, CA 93444
Phone (805) 929-1982

150 S Mary Ave
Ste 4
Nipomo, CA 93444
Phone (805) 929-1982

125 S Frontage Rd
Nipomo, CA 93444
Phone (805) 550-8579

Organizations & group practices 2

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1235463944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S MARY AVE STE 4",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934447821",
            "telephone_number": "805-929-1982",
            "fax_number": "805-929-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S MARY AVE STE 4",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934447821",
            "telephone_number": "805-929-1982",
            "fax_number": "805-929-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "BEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100188",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235463944",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "FI860A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II (GROUP) NPI",
            "identifier": "1346539095",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE I (INDIVIDUAL) NPI",
            "identifier": "1235463944",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nipomo, CA

Sources for this page

Verify at the official NPI Registry.