Caleb Poon

Primary specialty

OptometristTaxonomy code 152W00000X

License

14768 Issued in CA

Practice address

1350 Travis Blvd # 1507a
Fairfield, CA 94533-4646

Phone

(707) 421-2020

Fax

(707) 425-4266

NPI assigned

Oct 1, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of California - School of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Caleb Poon O D Inc

  • Optometrist
  • Santa Rosa, CA
  • NPI 1588250625
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1285061598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 TRAVIS BLVD # 1507A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 TRAVIS BLVD # 1507A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334646",
            "telephone_number": "707-421-2020",
            "fax_number": "707-425-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POON",
        "first_name": "CALEB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khristal Rochelle Ponce, LCSW
• Macayla Josephine Ponce
• Melissa Mary Ponce
• Vanessa-June Ruthchiet Pontillas, NP
• Jenny L Ponting, LCSW
• Kulbir K Pooni
• Hailey Ann Popovich
• Nicole Diana Porter
• Nina Porter, MD
• Theresa Porter, RADT

• Optometrist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.

Verify at the official NPI Registry.