Individual provider Active NPI

Rachel Niskanen, OD

  • Optometrist
  • Oceanside, CA
National Provider Identifier
1467065797
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34663 Issued in CA
Practice address
3915 Mission Ave Ste 2
Oceanside, CA 92058-7801
Phone
(760) 757-8771
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34663 CA Primary

Addresses

Primary practice location

3915 Mission Ave Ste 2
Oceanside, CA 92058-7801

Mailing address

3915 Mission Ave Ste 2
Oceanside, CA 92058-7801
Phone (760) 757-8771

Other practice location 1

711 Grand Ave Ste 2
Carlsbad, CA 92008-2485
Phone (760) 729-4327

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
I20201019003146 CA Practitioner - Optometry 3274953989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adam Rosa OD IncGroup PAC ID 7517342348, 3 clinicians

Practice addresses (Care Compare)

3915 Mission Ave
Suite 2
Oceanside, CA 92058-7801
Phone (760) 757-8771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34663CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Vision Clinic Optometry Inc Optometrist CurrentSince Oct 14, 2020 Accepting new patients
Adam Rosa OD Inc Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Focus Vision Clinic Optometry Inc Optometrist PastSince Aug 1, 2021 Accepting new patients
North Coast Optometry Optometrist PastSince Apr 24, 2022 Accepting new patients

Locations

1668 E Second St
Ste B
Beaumont, CA 92223
Phone (951) 845-4749

711 Grand Ave
Ste 2
Carlsbad, CA 92008
Phone (760) 729-4327

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": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1467065797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 MISSION AVE STE 2",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587801",
            "telephone_number": "760-757-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 MISSION AVE STE 2",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587801",
            "telephone_number": "760-757-8771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Grand Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920082485",
            "country_code": "US",
            "telephone_number": "760-729-4327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISKANEN",
        "first_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.