Individual provider Active NPI

Lesli Diane Handmacher, O.D.

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1245359090
Registry record updated Feb 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5867 Issued in CA
Practice address
1508 Walnut St Ste D
Walnut Square
Berkeley, CA 94709-1564
Phone
(510) 540-5555
Fax
(510) 548-3999
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5867 CA Primary

Addresses

Primary practice location

1508 Walnut St Ste D
Walnut Square
Berkeley, CA 94709-1564

Mailing address

1508 Walnut St Ste D
Berkeley, CA 94709-1564
Phone (510) 540-5555

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
I20080415000319 CA Practitioner - Optometry 5597843607 Practice locations: Berkeley, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1245359090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 WALNUT ST STE D",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091564",
            "telephone_number": "510-540-5555",
            "fax_number": "510-548-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 WALNUT ST STE D",
            "address_2": "WALNUT SQUARE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091564",
            "telephone_number": "510-540-5555",
            "fax_number": "510-548-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANDMACHER",
        "first_name": "LESLI",
        "middle_name": "DIANE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.