Active NPI
Kurt Allen Lundquist, O.D.
- Optometrist
- Menifee, CA
National Provider Identifier
1447225297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9751T
- Practice address
- 30107 Haun Rd
Menifee, CA 92584-6825 - Phone
- (951) 434-6291
- Fax
- (951) 672-2137
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9751T | CA | Primary |
Addresses
Primary practice location
30107 Haun Rd
Menifee, CA 92584-6825
Mailing address
34746 Bitter Root CT
Murrieta, CA 92563-3397
Phone (951) 599-0866
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120216000451 | CA | Practitioner - Optometry | 2860650124 | Practice locations: Menifee, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9751T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adam Rosa OD Inc | Optometrist | Past | Accepting new patients |
| National Vision, Inc. | Past | Accepting new patients | |
| North Coast Optometry | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
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- Oceanside, CA
- NPI 1518134246
-
- Optometrist
- Oceanside, CA
- NPI 1992450027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487462400000",
"number": "1447225297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34746 BITTER ROOT CT",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925633397",
"telephone_number": "951-599-0866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30107 HAUN RD",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925846825",
"telephone_number": "951-434-6291",
"fax_number": "951-672-2137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDQUIST",
"first_name": "KURT",
"middle_name": "ALLEN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2017-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9751T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.