Individual provider Active NPI

Esfandiar Jason Sabet-Peyman, M.D.

  • Ophthalmology Physician
  • Fullerton, CA
National Provider Identifier
1356664429
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A109912 Issued in CA
Practice address
301 W Bastanchury Rd Ste 190
Fullerton, CA 92835-3429
Phone
(714) 449-1940
Fax
(714) 449-1988
NPI assigned
Mar 3, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Johns Hopkins University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1431 N Harbor Blvd
Fullerton, CA 92835-4105
Phone (714) 449-1940

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

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
I20140731002532 CA Practitioner - Ophthalmology 1052569613 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109912CAMDOphthalmology Physician

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. Past Accepting new patients
Dameron Hospital Association Past Accepting new patients
Advanced Artificial Eyes PastSince May 18, 2015 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2012-01121 NC
Ophthalmology Physician 207W00000X A109912 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

301 W Bastanchury Rd Ste 190
Fullerton, CA 92835-3429

Mailing address

301 W Bastanchury Rd Ste 190
Fullerton, CA 92835-3429
Phone (714) 449-1940

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 19, 2024.

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1356664429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 190",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353429",
            "telephone_number": "714-449-1940",
            "fax_number": "714-449-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 190",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353429",
            "telephone_number": "714-449-1940",
            "fax_number": "714-449-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABET-PEYMAN",
        "first_name": "ESFANDIAR",
        "middle_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-03",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2012-01121",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A109912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.