Individual provider Active NPI

Sheryl Ann Bruce, OD

  • Optometrist
  • Torrance, CA
National Provider Identifier
1457478638
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11016T Issued in CA
Practice address
3858 W Carson St
Ste 110
Torrance, CA 90503-6705
Phone
(310) 539-7100
Fax
(310) 539-7121
NPI assigned
Mar 23, 2007
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11016T CA Primary

Addresses

Primary practice location

3858 W Carson St
Ste 110
Torrance, CA 90503-6705

Mailing address

3858 W Carson St
Ste 110
Torrance, CA 90503-6705
Phone (310) 539-7100

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000471 CA Practitioner - Optometry 9537223458 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Alissa Wald and Associates Optometry IncGroup PAC ID 3779470380, 5 clinicians
Woodbridge Optometry IncGroup PAC ID 6901181510, 6 clinicians

Practice addresses (Care Compare)

1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3875
Phone (714) 545-9162

3858 W Carson St
Suite 110
Torrance, CA 90503-6705
Phone (310) 792-6200

4505 Barranca Pkwy
Suite C
Irvine, CA 92604-4797
Phone (949) 857-0676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11016TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Vision Center a Professional Optometry Corporation Optometrist CurrentSince Aug 27, 2014 Accepting new patients
Costco Wholesale Corporation Past Accepting new patients
Kyj Optometry Professional Corporation Optometrist PastSince Aug 27, 2014 Accepting new patients

Locations

3858 W Carson St
Ste 110
Torrance, CA 90503
Phone (310) 539-7100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1457478638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3858 W CARSON ST",
            "address_2": "STE 110",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036705",
            "telephone_number": "310-539-7100",
            "fax_number": "310-539-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3858 W CARSON ST",
            "address_2": "STE 110",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036705",
            "telephone_number": "310-539-7100",
            "fax_number": "310-539-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "SHERYL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11016T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.