NPIMap

Organization Active NPI

Craig Fellers OD Inc

Doing business as Midtown Optometry

  • Occupational Vision Optometrist
  • Santa Cruz, CA
National Provider Identifier
1427446749
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Vision OptometristTaxonomy code 152WX0102X
License
OPT14458TLG Issued in CA
Legal business name
CRAIG FELLERS OD INC
Doing business as
Midtown Optometry
Practice address
550 Water St Ste J5
Santa Cruz, CA 95060-4135
Phone
(831) 426-7172
NPI assigned
Jan 8, 2015
Last updated
Jan 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Authorized official

Name
Dr. Craig Fellers, ODNPI 1194089110
Title
President
Phone
(831) 426-7172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT14458TLG CA
Corneal and Contact Management Optometrist 152WC0802X OPT14458TLG CA
Sports Vision Optometrist 152WS0006X OPT14458TLG CA
Occupational Vision Optometrist 152WX0102X OPT14458TLG CA Primary

Addresses

Primary practice location

550 Water St Ste J5
Santa Cruz, CA 95060-4135

Mailing address

550 Water St Ste J5
Santa Cruz, CA 95060-4135
Phone (831) 426-7172

Other names 1

  • Midtown Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150408000161 CA Part B Supplier - Clinic/Group Practice 0345568184 Receives reassigned benefits from 4 practitioners
Practice locations: Santa Cruz, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1427446749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WATER ST STE J5",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604135",
            "telephone_number": "831-426-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WATER ST STE J5",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604135",
            "telephone_number": "831-426-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG FELLERS OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "FELLERS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-426-7172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT14458TLG",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT14458TLG",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "OPT14458TLG",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "OPT14458TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.