Individual provider Active NPI

Brandon Decaluwe

  • Ophthalmology Physician
  • Banning, CA
National Provider Identifier
1316365521
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A154285 Issued in CA
Practice address
6109 W Ramsey St
Banning, CA 92220-3051
Phone
(951) 845-0313
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A154285 CA Primary

Addresses

Primary practice location

6109 W Ramsey St
Banning, CA 92220-3051

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

1450 San Pablo St Fl 4
Los Angeles, CA 90033
Phone (323) 442-6335

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180605003180 CA Practitioner - Ophthalmology 8123383569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

6109 W Ramsey St
Banning, CA 92220-3051
Phone (909) 845-0313

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A154285CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Family Medicine GP Current Accepting new patients
Cassidy Medical Group Inc. Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group Ophthalmology CurrentSince Jan 1, 2024 Accepting new patients
Beaver Medical Group P C CurrentSince Jul 9, 2019 Accepting new patients
Beaver Medical Group P C Ophthalmology CurrentSince Jul 9, 2019 Accepting new patients
Redlands Community Hospital Past Accepting new patients
Beaver Medical Group P C Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

6109 W Ramsey St
Banning, CA 92220
Phone (909) 845-0313

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

2 W Fern Ave
#1112
Redlands, CA 92373

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

145 Thunder Dr
#1182
Vista, CA 92083
Phone (760) 941-9002

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bdecaluwe11153@epiclp.direct-ci.com

Organizations & group practices 12

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

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1316365521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203051",
            "telephone_number": "951-845-0313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 San Pablo St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-442-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECALUWE",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A154285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.