Individual provider Active NPI

Erica Urrea, O.D.

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1386910552
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14171 Issued in CA
Practice address
888 S Disneyland Dr
Suite 100
Anaheim, CA 92802-1847
Phone
(714) 399-0678
Fax
(714) 276-6489
NPI assigned
Mar 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14171 CA Primary

Addresses

Primary practice location

888 S Disneyland Dr
Suite 100
Anaheim, CA 92802-1847

Mailing address

5991 E Spring St
Long Beach, CA 90808-3752
Phone (562) 938-9945

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20121113000523 CA Practitioner - Optometry 9739330176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14171CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Eyecare Optometry Inc Optometrist CurrentSince Nov 3, 2012 Accepting new patients
Dpmotikonrca LLC CurrentSince Mar 30, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 20, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 20, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group Past Accepting new patients
Eyecare Specialists Medical Group, Inc. Optometrist Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

425 W Bonita Ave
Ste 110B
San Dimas, CA 91773
Phone (909) 394-0462

1335 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (562) 867-0811

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1386910552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5991 E SPRING ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908083752",
            "telephone_number": "562-938-9945",
            "fax_number": "562-496-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S DISNEYLAND DR",
            "address_2": "SUITE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928021847",
            "telephone_number": "714-399-0678",
            "fax_number": "714-276-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URREA",
        "first_name": "ERICA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-31",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.