Individual provider Active NPI

Suparna Bajaj, OD

  • Optometrist
  • Canyon Country, CA
National Provider Identifier
1295403921
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34898TLG Issued in CA
Practice address
16522 Soledad Canyon Rd
Canyon Country, CA 91387-3215
Phone
(661) 567-0260
NPI assigned
Aug 30, 2021
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34898TLG CA Primary

Addresses

Primary practice location

16522 Soledad Canyon Rd
Canyon Country, CA 91387-3215

Mailing address

28212 Foxlane Dr
Santa Clarita, CA 91351-1201
Phone (562) 355-0577

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
I20220518001811 CA Practitioner - Optometry 9436536109 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.12 of 100Reported as group
Quality
96.62
Improvement activities
40
Cost
42.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34898CAMDChiropractor
34898TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bajaj Dhakal Optometric Corporation Optometrist CurrentSince Dec 30, 2024 Accepting new patients
Athena Brasfield OD a Professional Corporation Optometrist CurrentSince Sep 1, 2023 Accepting new patients
Dr. Gregory L. McFarland, O.D., P.C Optometrist PastSince Apr 9, 2018 Accepting new patients

Locations

16522 Soledad Canyon Rd
Canyon Country, CA 91387
Phone (562) 355-0577

52565 Harrison St
Ste 105
Coachella, CA 92236
Phone (760) 347-6636

82227 US Highway 111
Ste B2
Indio, CA 92201
Phone (760) 347-6636

400 S Farrell Dr
Ste B130
Palm Springs, CA 92262
Phone (760) 347-6636

Organizations & group practices 4

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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1295403921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28212 FOXLANE DR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913511201",
            "telephone_number": "562-355-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16522 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913873215",
            "telephone_number": "661-567-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJAJ",
        "first_name": "SUPARNA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34898TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

Verify at the official NPI Registry.