Organization Active NPI

Plaza Lane Optometry

  • Optometrist
  • Santa Cruz, CA
National Provider Identifier
1306921457
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT7576TPA Issued in CA
Legal business name
PLAZA LANE OPTOMETRY
Practice address
1537 Pacific Ave
Suite 100
Santa Cruz, CA 95060-3942
Phone
(831) 429-2020
Fax
(831) 429-2945
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Dr. Brittany Heyano, O.D.NPI 1558917377
Title
Owner
Phone
(831) 429-2020

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT7576TPA CA Primary

Addresses

Primary practice location

1537 Pacific Ave
Suite 100
Santa Cruz, CA 95060-3942

Mailing address

1537 Pacific Ave
Suite 100
Santa Cruz, CA 95060-3942
Phone (831) 429-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231031000438 CA Part B Supplier - Clinic/Group Practice 3870949639 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Cruz, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1306921457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 PACIFIC AVE",
            "address_2": "SUITE 100",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603942",
            "telephone_number": "831-429-2020",
            "fax_number": "831-429-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 PACIFIC AVE",
            "address_2": "SUITE 100",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603942",
            "telephone_number": "831-429-2020",
            "fax_number": "831-429-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA LANE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "HEYANO",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-429-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT7576TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.