Individual provider Active NPI

Samuel S. Masters, M.D.

  • Ophthalmology Physician
  • Santa Cruz, CA
National Provider Identifier
1265588784
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G55792 Issued in CA
Practice address
1663 Dominican Way
Suite 212
Santa Cruz, CA 95065-1527
Phone
(831) 475-5375
Fax
(831) 475-7229
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G55792 CA Primary

Addresses

Primary practice location

1663 Dominican Way
Suite 212
Santa Cruz, CA 95065-1527

Mailing address

1663 Dominican Way
Suite 212
Santa Cruz, CA 95065-1527
Phone (831) 475-5375

Other identifiers 1

IdentifierTypeStateIssuer
00G557920MedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141108000370 CA Practitioner - Ophthalmology 4486767910 Practice locations: Santa Cruz, CA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1663 Dominican Way
Suite 212
Santa Cruz, CA 95065-1556
Phone (831) 475-5375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G55792CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Ophthalmology Past Accepting new patients

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1265588784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 DOMINICAN WAY",
            "address_2": "SUITE 212",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651527",
            "telephone_number": "831-475-5375",
            "fax_number": "831-475-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 DOMINICAN WAY",
            "address_2": "SUITE 212",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651527",
            "telephone_number": "831-475-5375",
            "fax_number": "831-475-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "SAMUEL",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G55792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G557920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.