Individual provider Active NPI

Joseph John Lasusky, O.D.

  • Optometrist
  • Concord, CA
National Provider Identifier
1447386917
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5553 TPL Issued in CA
Practice address
1812 Galindo St
Concord, CA 94520-2477
Phone
(925) 825-2020
Fax
(925) 825-2073
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5553 TPL CA Primary

Addresses

Primary practice location

1812 Galindo St
Concord, CA 94520-2477

Mailing address

1812 Galindo St
Concord, CA 94520-2477
Phone (925) 825-2020

Other identifiers 1

IdentifierTypeStateIssuer
SD0055531MedicaidCA

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
5553 TPLCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Site Optometrist PastSince Jun 20, 2003 Accepting new patients
Advanced Eyecare Professional Optometric Group Optometrist PastSince May 28, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1447386917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 GALINDO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202477",
            "telephone_number": "925-825-2020",
            "fax_number": "925-825-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 GALINDO ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202477",
            "telephone_number": "925-825-2020",
            "fax_number": "925-825-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASUSKY",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5553 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0055531",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; 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.