Individual provider Active NPI

Arya Saidi, OD

  • Optometrist
  • Lake Forest, CA
National Provider Identifier
1396475125
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35122-TLG Issued in CA
Practice address
18832 Vista Portola
Lake Forest, CA 92679-1103
Phone
(949) 702-2686
NPI assigned
Jun 14, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35122-TLG CA Primary

Addresses

Primary practice location

18832 Vista Portola
Lake Forest, CA 92679-1103

Mailing address

18832 Vista Portola
Lake Forest, CA 92679-1103
Phone (949) 702-2686

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
I20231027000591 CA Practitioner - Optometry 9537515531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Dr Latisha Patel a Professional Optometric CorporationGroup PAC ID 0840645479, 4 clinicians

Practice addresses (Care Compare)

5030 Hamner Ave
Eastvale, CA 91752-1009
Phone (951) 361-9092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT35122-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Latisha Patel a Professional Optometric Corporation Optometrist CurrentSince Oct 1, 2023 Accepting new patients

Locations

5030 Hamner Ave
Eastvale, CA 91752
Phone (951) 361-9092

Organizations & group practices 1

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1396475125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18832 VISTA PORTOLA",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926791103",
            "telephone_number": "949-702-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18832 VISTA PORTOLA",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926791103",
            "telephone_number": "949-702-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAIDI",
        "first_name": "ARYA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35122-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.