Active NPI
Samuel S. Masters, M.D.
- Ophthalmology Physician
- Santa Cruz, CA
National Provider Identifier
1265588784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G55792
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G557920 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| G55792 | CA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.