NPIMap

Organization Active NPI

Vista Center for the Blind and Visually Impaired

  • Low Vision Rehabilitation Optometrist
  • Palo Alto, CA
National Provider Identifier
1467409979
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
220000439 Issued in CA
Legal business name
VISTA CENTER FOR THE BLIND AND VISUALLY IMPAIRED
Practice address
2500 El Camino Real Ste 100
Palo Alto, CA 94306
Phone
(650) 858-0202
Fax
(650) 858-0214
NPI assigned
May 28, 2006
Last updated
Dec 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Authorized official

Name
Ms. Karae Lisle
Title
Executive Director
Phone
(650) 858-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 220000439 CA Primary

Addresses

Primary practice location

2500 El Camino Real Ste 100
Palo Alto, CA 94306

Mailing address

2500 El Camino Real Ste 100
Palo Alto, CA 94306-1723
Phone (650) 858-0202

Other identifiers 1

IdentifierTypeStateIssuer
CMM70427FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308000481 CA Part B Supplier - Clinic/Group Practice 9133173693 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: Palo Alto, CA; San Jose, CA; Santa Cruz, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Vista Center for the Blind3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1467409979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 EL CAMINO REAL STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061723",
            "telephone_number": "650-858-0202",
            "fax_number": "650-858-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 EL CAMINO REAL STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "94306",
            "telephone_number": "650-858-0202",
            "fax_number": "650-858-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA CENTER FOR THE BLIND AND VISUALLY IMPAIRED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "LISLE",
        "authorized_official_first_name": "KARAE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "650-858-0202",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "220000439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70427F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.