Individual provider Active NPI

Irena Bekhtel, OD

  • Optometrist
  • Stockton, CA
National Provider Identifier
1366544363
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12748 Issued in CA
Practice address
4762 Saint Andrews Dr
Stockton, CA 95219-1915
Phone
(209) 594-0554
NPI assigned
Sep 1, 2006
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4104 MA
Optometrist 152W00000X 12748 CA Primary
Optometrist 152W00000X OPC3279 FL

Addresses

Primary practice location

4762 Saint Andrews Dr
Stockton, CA 95219-1915

Mailing address

4915 Claremont Ave
Stockton, CA 95207-5707
Phone (209) 956-3323

Other identifiers 8

IdentifierTypeStateIssuer
0313807MedicaidMA
E314OtherMAHPHC
410376OtherMATUFTS
0019950OtherMANHP
9607387-004OtherMACIGNA
1274OtherCAEYEMED
W16212OtherMABCBS
10578OtherMADAVIS

Other names 1

  • Dr. Irena Bekhtel Former name

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
I20060111001184 CA Practitioner - Optometry 0244292548 Practice locations: Stockton, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3279FLMDOptometrist
12748CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Usv Optical Inc Optometrist Past Accepting new patients
Usv Optical Inc. Past Accepting new patients

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1366544363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 CLAREMONT AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075707",
            "telephone_number": "209-956-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4762 SAINT ANDREWS DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191915",
            "telephone_number": "209-594-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEKHTEL",
        "first_name": "IRENA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4104",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12748",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3279",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0313807",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "E314",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "410376",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0019950",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9607387-004",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "1274",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W16212",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "10578",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENA",
            "last_name": "BEKHTEL",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.