Individual provider Active NPI

Dennis J Guerrieri, O.D.

  • Optometrist
  • Davis, CA
National Provider Identifier
1366436917
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8478T Issued in CA
Practice address
231 C St
Davis, CA 95616-4521
Phone
(530) 758-4000
Fax
(530) 758-4016
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8478T CA Primary

Addresses

Primary practice location

231 C St
Davis, CA 95616-4521

Mailing address

231 C St
Davis, CA 95616-4521
Phone (530) 758-4000

Other identifiers 1

IdentifierTypeStateIssuer
SD0084781MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120207000260 CA Practitioner - Optometry 6002080132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8478TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis J Guerrieri OD Inc Optometrist CurrentSince Mar 10, 2016 Accepting new patients
Eye Sea Optometry Apc Optometrist CurrentSince Apr 13, 2025 Accepting new patients

Locations

231 C St
Davis, CA 95616
Phone (530) 758-4000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1366436917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 C ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164521",
            "telephone_number": "530-758-4000",
            "fax_number": "530-758-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 C ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164521",
            "telephone_number": "530-758-4000",
            "fax_number": "530-758-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRIERI",
        "first_name": "DENNIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8478T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0084781",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.