NPIMap

Organization Active NPI

Robert B Pendleton MD PHD Inc

Doing business as Pendleton Eye Center A Professional Corporation

  • Ophthalmology Physician
  • Oceanside, CA
National Provider Identifier
1386848216
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G83487 Issued in CA
Legal business name
ROBERT B PENDLETON MD PHD INC
Doing business as
Pendleton Eye Center A Professional Corporation
Practice address
3637 Vista Way
Oceanside, CA 92056-4522
Phone
(760) 758-2008
Fax
(760) 758-2004
NPI assigned
Jun 13, 2007
Last updated
Jan 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Robert Brian Pendleton, MD PHDNPI 1770556060
Title
Medical Director
Phone
(760) 758-2008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X G83487 CA
Durable Medical Equipment & Medical Supplies 332B00000X NU
Ophthalmology Physician 207W00000X G83487 CA Primary

Addresses

Primary practice location

3637 Vista Way
Oceanside, CA 92056-4522

Mailing address

3637 Vista Way
Oceanside, CA 92056-4522
Phone (760) 758-2008

Other identifiers 1

IdentifierTypeStateIssuer
00G834870MedicaidCA

Other names 1

  • Pendleton Eye Center A Professional Corporation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070724000849 CA Part B Supplier - Clinic/Group Practice 4789785445 Receives reassigned benefits from 2 practitioners
Practice locations: Oceanside, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1386848216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-758-2008",
            "fax_number": "760-758-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-758-2008",
            "fax_number": "760-758-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B PENDLETON MD PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "760-758-2008",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "G83487",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G83487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G834870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pendleton Eye Center A Professional Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.