NPIMap

Organization Active NPI

Fifth Optometric Care of California

Doing business as Eye Styles for Lifestyles Optometry

  • Optometrist
  • Lake Forest, CA
National Provider Identifier
1275319451
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FIFTH OPTOMETRIC CARE OF CALIFORNIA
Doing business as
Eye Styles for Lifestyles Optometry
Practice address
22681 Lake Forest Dr Ste A2
Lake Forest, CA 92630-1799
Phone
(949) 837-2121
NPI assigned
Sep 5, 2023
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FIFTH OPTOMETRIC CARE OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Brittany Harrison
Title
Delegated Official
Phone
(512) 316-4603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

22681 Lake Forest Dr Ste A2
Lake Forest, CA 92630-1799

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985

Other names 1

  • Eye Styles for Lifestyles Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230808001819 CA Part B Supplier - Clinic/Group Practice 4284096298 Receives reassigned benefits from 62 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bakersfield, CA; Turlock, CA; Taft, CA; San Jose, CA; Rancho Cordova, CA; Lake Forest, CA; Elk Grove, CA; El Cerrito, CA…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Fifth Optometric Care O11 organizations share this tax ID, including this one
Part of
Fifth Optometric Care O

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1275319451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22681 LAKE FOREST DR STE A2",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301799",
            "telephone_number": "949-837-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH OPTOMETRIC CARE OF CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIFTH OPTOMETRIC CARE OF CALIFORNIA",
        "enumeration_date": "2023-09-05",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "512-316-4603"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Styles for Lifestyles Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.