NPIMap

Organization Active NPI

Eyecare Specialists Medical Group, Inc

Doing business as Atlantis Eyecare

  • Ophthalmology Physician
  • Montebello, CA
National Provider Identifier
1407328420
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYECARE SPECIALISTS MEDICAL GROUP, INC
Doing business as
Atlantis Eyecare
Practice address
229 E Beverly Blvd
Montebello, CA 90640-3776
Phone
(323) 728-7998
Fax
(323) 728-5041
NPI assigned
Jan 2, 2019
Last updated
Nov 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Authorized official

Name
Felisa Marisol Galindo
Title
Credentialing Supervisor
Phone
(626) 305-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

229 E Beverly Blvd
Montebello, CA 90640-3776

Mailing address

1595 E 17TH St
Santa Ana, CA 92705-8506
Phone (714) 399-0678

Other names 1

  • ATLANTIS EYECARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000884 CA Part B Supplier - Clinic/Group Practice 2264322080 Receives reassigned benefits from 16 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Torrance, CA; Downey, CA; Santa Ana, CA; Palm Desert, CA; Montebello, CA; Laguna Hills, CA; Long Beach, CA; Anaheim, CA…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Spec Medical10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1407328420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058506",
            "telephone_number": "714-399-0678",
            "fax_number": "714-276-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 E BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403776",
            "telephone_number": "323-728-7998",
            "fax_number": "323-728-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE SPECIALISTS MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "GALINDO",
        "authorized_official_first_name": "FELISA",
        "authorized_official_middle_name": "MARISOL",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "626-305-9100"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATLANTIS EYECARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ATLANTIS EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.