Individual provider Active NPI

Michael Alan Goldsmid, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1356304067
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-7475T Issued in CA
Practice address
3750 Sports Arena Blvd
Suite 9
San Diego, CA 92110-5129
Phone
(619) 224-2879
Fax
(619) 224-1311
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-7475T CA Primary
Corneal and Contact Management Optometrist 152WC0802X OPT-7475T CA

Addresses

Primary practice location

3750 Sports Arena Blvd
Suite 9
San Diego, CA 92110-5129

Mailing address

3750 Sports Arena Blvd
Suite 9
San Diego, CA 92110-5129
Phone (619) 224-2879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-7475TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince May 29, 2019 Accepting new patients

Locations

3750 Sports Arena Blvd
Ste 9
San Diego, CA 92110
Phone (619) 224-2879

Organizations & group practices 2

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1356304067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 SPORTS ARENA BLVD",
            "address_2": "SUITE 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105129",
            "telephone_number": "619-224-2879",
            "fax_number": "619-224-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 SPORTS ARENA BLVD",
            "address_2": "SUITE 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105129",
            "telephone_number": "619-224-2879",
            "fax_number": "619-224-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMID",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT-7475T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT-7475T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.