Individual provider Active NPI

Amy Michelle Brown, OD

  • Optometrist
  • Woodland, CA
National Provider Identifier
1265508576
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CA 11043T Issued in CA
Practice address
421 Pioneer Ave Ste B
Woodland, CA 95776-4948
Phone
(530) 661-0300
Fax
(530) 661-0501
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

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 CA 11043T CA Primary

Addresses

Primary practice location

421 Pioneer Ave Ste B
Woodland, CA 95776-4948

Mailing address

421 Pioneer Ave Ste B
Woodland, CA 95776-4948
Phone (530) 661-0300

Other identifiers 1

IdentifierTypeStateIssuer
SD0110430MedicaidCA

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
I20111219000525 CA Practitioner - Optometry 9638280340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

421 Pioneer Ave
Suite B
Woodland, CA 95776-4948
Phone (530) 661-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11043CAMDMental Health Counselor
CA 11043TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes of Woodland Optometry, Apc Optometrist CurrentSince Apr 1, 2000 Accepting new patients

Locations

421 Pioneer Ave
Ste B
Woodland, CA 95776
Phone (530) 661-0300

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265508576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 PIONEER AVE STE B",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957764948",
            "telephone_number": "530-661-0300",
            "fax_number": "530-661-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 PIONEER AVE STE B",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957764948",
            "telephone_number": "530-661-0300",
            "fax_number": "530-661-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA 11043T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0110430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.