Individual provider Active NPI

Craig Sultan, O.D.

  • Optometrist
  • Napa, CA
National Provider Identifier
1376627539
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6569T Issued in CA
Practice address
1328 Pearl St
Napa, CA 94559-2525
Phone
(707) 254-2020
Fax
(707) 254-2036
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6569T CA Primary

Addresses

Primary practice location

1328 Pearl St
Napa, CA 94559-2525

Mailing address

1328 Pearl St
Napa, CA 94559-2525
Phone (707) 254-2020

Other identifiers 1

IdentifierTypeStateIssuer
SD0006691MedicaidCA

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
I20080305000623 CA Practitioner - Optometry 3173608817 Receives reassigned benefits from 1 practitioner
Practice locations: Napa, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1328 Pearl St
Napa, CA 94559-2525
Phone (707) 254-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6569TCAMDOptometrist

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1376627539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 PEARL ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592525",
            "telephone_number": "707-254-2020",
            "fax_number": "707-254-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 PEARL ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592525",
            "telephone_number": "707-254-2020",
            "fax_number": "707-254-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTAN",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6569T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0006691",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.