Individual provider Active NPI

Lauren B Gonzalez, OD

  • Optometrist
  • Santa Barbara, CA
National Provider Identifier
1245519966
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14175 TLG Issued in CA
Practice address
29 W Anapamu St
Santa Barbara, CA 93101-3149
Phone
(805) 681-1761
Fax
(805) 681-1768
NPI assigned
Aug 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14175 TLG CA Primary

Addresses

Primary practice location

29 W Anapamu St
Santa Barbara, CA 93101-3149

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1761

Other identifiers 1

IdentifierTypeStateIssuer
OPT14175OtherCACA STATE LICENSE

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
I20130205000145 CA Practitioner - Optometry 5991959678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone (805) 681-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14175 TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Dec 19, 2012 Accepting new patients
Sansum Clinic CurrentSince Dec 19, 2012 Accepting new patients
Sansum Clinic Past Accepting new patients

Locations

29 W Anapamu St
Santa Barbara, CA 93101
Phone (805) 681-8950

3916 State St
Ste 1C
Santa Barbara, CA 93105
Phone (805) 681-8980

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

Interoperability endpoints

  • Direct secure messaging: lgonzalez19415@direct.wavekesselrun.org
  • Direct secure messaging: lgonzalez760510@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1245519966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 W ANAPAMU ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931013149",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LAUREN",
        "middle_name": "B",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14175 TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "OPT14175",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.