Individual provider Active NPI

John W Arteaga, OD

  • Optometrist
  • Fresno, CA
National Provider Identifier
1346216926
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6159TPL Issued in CA
Practice address
4041 N Fresno St
Ste 102
Fresno, CA 93726-4037
Phone
(559) 227-7512
Fax
(559) 227-7574
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6159TPL CA Primary

Addresses

Primary practice location

4041 N Fresno St
Ste 102
Fresno, CA 93726-4037

Mailing address

4041 N Fresno St
Ste 102
Fresno, CA 93726-4037
Phone (559) 227-7512

Other identifiers 1

IdentifierTypeStateIssuer
SD0061590MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6159TPLCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1346216926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 N FRESNO ST",
            "address_2": "STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264037",
            "telephone_number": "559-227-7512",
            "fax_number": "559-227-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 N FRESNO ST",
            "address_2": "STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264037",
            "telephone_number": "559-227-7512",
            "fax_number": "559-227-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARTEAGA",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6159TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0061590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.