Elisabeth Sarah Swan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9676T Issued in CA

Practice address

4335 Hazel Ave
Fair Oaks, CA 95628-6669

Phone

(916) 966-6080

Fax

(916) 966-6919

NPI assigned

Oct 25, 2005

Last updated

Oct 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elisabeth S Swan Optometry Inc

  • Optometrist
  • Fair Oaks, CA
  • NPI 1215174867
  Authorized official Same address or phone
• First Optometric Care of Northern California PC

  • Optometrist
  • Rancho Cordova, CA
  • NPI 1154972404
  NPD
• First Optometric Care of Northern California PC

  dba East Hills Vision Care Optometry

  • Optometrist
  • San Jose, CA
  • NPI 1487537452
  NPD

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1356331938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4335 HAZEL AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286669",
            "telephone_number": "916-966-6080",
            "fax_number": "916-966-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4335 HAZEL AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286669",
            "telephone_number": "916-966-6080",
            "fax_number": "916-966-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "ELISABETH",
        "middle_name": "SARAH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9676T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "SD0096760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Delaney Swanson, LVN
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• Lydia Tabb
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• Optometrist in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.