Individual provider Active NPI

Joseph Andrew Ibarra, O.D.

  • Optometrist
  • La Puente, CA
National Provider Identifier
1235684879
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33578 Issued in CA
Practice address
15330 Amar Rd Ste a
La Puente, CA 91744-2001
Phone
(626) 961-0432
NPI assigned
Aug 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 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 33578 CA Primary

Addresses

Primary practice location

15330 Amar Rd Ste a
La Puente, CA 91744-2001

Mailing address

2154 Saticoy St
Pomona, CA 91767-2411
Phone (626) 421-8153

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
I20161013001779 CA Practitioner - Optometry 1052609609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul T Urrea M D M P H IncGroup PAC ID 9638130735, 7 clinicians

Practice addresses (Care Compare)

4560 E Cesar E Chavez Ave
Los Angeles, CA 90022-1168
Phone (323) 980-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Hernandez Optometry Inc Optometrist CurrentSince Feb 4, 2026 Accepting new patients
Edward P. & Diane M. Hernandez Optometrist CurrentSince Sep 1, 2016 Accepting new patients
DRS. Edward P. and Diane M. Hernandez, O.D. Optometrist CurrentSince Sep 1, 2016 Accepting new patients
Paul T Urrea M D M P H Inc Optometrist CurrentSince Feb 21, 2022 Accepting new patients

Locations

6134 Pacific Blvd
Huntington Park, CA 90255
Phone (323) 589-3381

15330 Amar Rd
Ste A
La Puente, CA 91744
Phone (626) 961-0432

4560 E Cesar E Chavez Ave
Los Angeles, CA 90022
Phone (323) 269-0411

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1235684879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 SATICOY ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672411",
            "telephone_number": "626-421-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15330 AMAR RD STE A",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917442001",
            "telephone_number": "626-961-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBARRA",
        "first_name": "JOSEPH",
        "middle_name": "ANDREW",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

Verify at the official NPI Registry.