Individual provider Active NPI

Amanda Meredith Hobbs Mercer, O.D.

  • Optometrist
  • Costa Mesa, CA
National Provider Identifier
1457559593
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13629 Issued in CA
Practice address
1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3814
Phone
(714) 545-9162
Fax
(714) 241-1345
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13629 CA Primary

Addresses

Primary practice location

1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3814

Mailing address

1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3814
Phone (714) 545-9162

Other names 1

  • Dr. Amanda Meredith Hobbs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150529001848 OR Practitioner - Optometry 5890896856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Eyecare LLCGroup PAC ID 5294972246, 3 clinicians

Practice addresses (Care Compare)

22400 Salamo Rd
Suite 100
West Linn, OR 97068-8269
Phone (503) 722-7737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13629CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentana Inc Optometrist CurrentSince May 1, 2015 Accepting new patients
Uptown Eyecare & Optical, P.C. Optometrist CurrentSince May 1, 2015 Accepting new patients
Caduceus Physicians Medical Group PastSince Jan 15, 2016 Accepting new patients

Locations

2370 W Burnside St
Portland, OR 97210
Phone (503) 228-3838

22400 Salamo Rd
Ste 100
West Linn, OR 97068
Phone (503) 722-7737

Organizations & group practices 4

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1457559593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ADAMS AVE",
            "address_2": "SUITE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263814",
            "telephone_number": "714-545-9162",
            "fax_number": "714-241-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ADAMS AVE",
            "address_2": "SUITE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263814",
            "telephone_number": "714-545-9162",
            "fax_number": "714-241-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "AMANDA",
        "middle_name": "MEREDITH HOBBS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HOBBS",
            "middle_name": "MEREDITH",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.