Active NPI
Cheryl Evelyn Alderson, O.D.
- Optometrist
- Lake Forest, CA
National Provider Identifier
1366521809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12946
- Practice address
- 21098 Bake Pkwy
Suite 110
Lake Forest, CA 92630-2163 - Phone
- (949) 597-0104
- NPI assigned
- Nov 3, 2006
- Last updated
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12946 | CA | Primary |
Addresses
Primary practice location
21098 Bake Pkwy
Suite 110
Lake Forest, CA 92630-2163
Mailing address
21098 Bake Pkwy
#110
Lake Forest, CA 92630-2163
Phone (949) 597-0104
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 2003
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
21098 Bake Pkwy
Suite 110
Lake Forest, CA 92630-2163
Phone (949) 597-0104
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12946 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients | |
| De la Pena Eye Clinic, a Medical Group, Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Optometrist
- Lake Forest, CA
- NPI 1922399864
-
dba DLP Eye Group
- Ophthalmology Physician
- Huntington Park, CA
- NPI 1518971464
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413331200000",
"number": "1366521809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21098 BAKE PKWY",
"address_2": "#110",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926302163",
"telephone_number": "949-597-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21098 BAKE PKWY",
"address_2": "SUITE 110",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926302163",
"telephone_number": "949-597-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALDERSON",
"first_name": "CHERYL",
"middle_name": "EVELYN",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2014-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.