Active NPI
Optima Ophthalmic Medical Associates, Inc
- Ophthalmology Physician
- Hayward, CA
National Provider Identifier
1285837484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G42418
- Legal business name
- OPTIMA OPHTHALMIC MEDICAL ASSOCIATES, INC
- Practice address
- 1237 B St
Hayward, CA 94541-2915 - Phone
- (510) 886-5497
- Fax
- (510) 886-6304
- NPI assigned
- Jun 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark R Mandel, MD
- Title
- Secretary Treasurer
- Phone
- (510) 886-3937
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G42418 | CA | Primary |
Addresses
Primary practice location
1237 B St
Hayward, CA 94541-2915
Mailing address
1229 B St
Hayward, CA 94541-2915
Phone (510) 886-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ80788Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081028000020 | CA | Part B Supplier - Clinic/Group Practice | 5890766869 |
Receives reassigned benefits from 5 practitioners 1 other NPI on this enrollment Practice locations: Hayward, CA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Ophthalmologic Surgery Clinic/Center
- Hayward, CA
- NPI 1346287414
5890766869
National Provider Directory
National Provider DirectoryLocations
1229 B St
Hayward, CA 94541
1237 B St
Hayward, CA 94541
Phone (510) 886-3937
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Orange, CA
- NPI 1013262104
CA, Ophthalmology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726704000000",
"number": "1285837484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 B ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945412915",
"telephone_number": "510-886-3937",
"fax_number": "510-886-4465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1237 B ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945412915",
"telephone_number": "510-886-5497",
"fax_number": "510-886-6304"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPTIMA OPHTHALMIC MEDICAL ASSOCIATES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-06",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A",
"authorized_official_last_name": "MANDEL",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "SECRETARY TREASURER",
"authorized_official_telephone_number": "510-886-3937",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "CA",
"license": "G42418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ80788Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.