Individual provider Active NPI

James Jacob Weyrich, O.D.

  • Optometrist
  • Santa Ana, CA
National Provider Identifier
1285770560
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7658T Issued in CA
Practice address
2018 E 17TH St
Santa Ana, CA 92705-8647
Phone
(714) 564-0222
Fax
(714) 564-9222
NPI assigned
Jan 30, 2007
Last updated
Mar 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7658T CA Primary

Addresses

Primary practice location

2018 E 17TH St
Santa Ana, CA 92705-8647

Mailing address

2018 E 17TH St
Santa Ana, CA 92705-8647
Phone (714) 564-0222

Other identifiers 1

IdentifierTypeStateIssuer
6541022MedicaidCA

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
I20101230000433 CA Practitioner - Optometry 0547458887 Practice locations: Santa Ana, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2018 E 17TH St
Santa Ana, CA 92705-8647
Phone (714) 564-0222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7658TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1285770560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058647",
            "telephone_number": "714-564-0222",
            "fax_number": "714-564-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058647",
            "telephone_number": "714-564-0222",
            "fax_number": "714-564-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYRICH",
        "first_name": "JAMES",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7658T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6541022",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.