Individual provider Active NPI

John Winton Elman, O.D.

  • Optometrist
  • Santa Monica, CA
National Provider Identifier
1417021361
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT4939T Issued in CA
Practice address
1431 7TH St
Ste. 101
Santa Monica, CA 90401-2637
Phone
(310) 395-5550
Fax
(310) 395-3398
NPI assigned
Nov 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT4939T CA Primary

Addresses

Primary practice location

1431 7TH St
Ste. 101
Santa Monica, CA 90401-2637

Mailing address

1431 7TH St
Ste. 101
Santa Monica, CA 90401-2637
Phone (310) 395-5550

Other identifiers 1

IdentifierTypeStateIssuer
SD0049390MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT4939TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
D. Kattengell O.D. Inc. Optometrist PastSince Sep 28, 2021 Accepting new patients

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417021361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 7TH ST",
            "address_2": "STE. 101",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012637",
            "telephone_number": "310-395-5550",
            "fax_number": "310-395-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 7TH ST",
            "address_2": "STE. 101",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012637",
            "telephone_number": "310-395-5550",
            "fax_number": "310-395-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMAN",
        "first_name": "JOHN",
        "middle_name": "WINTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT4939T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0049390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.