NPIMap

Organization Active NPI

Eyecare Solutions Inc

  • Ophthalmology Physician
  • Encinitas, CA
National Provider Identifier
1467519470
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A41008
Legal business name
EYECARE SOLUTIONS INC
Practice address
477 N El Camino Real
C202
Encinitas, CA 92024
Phone
(760) 631-3500
Fax
(760) 753-5150
NPI assigned
Jan 2, 2007
Last updated
Dec 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Dr. Christian Dovenbarger
Title
Administrator
Phone
(760) 631-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A41008 Primary

Addresses

Primary practice location

477 N El Camino Real
C202
Encinitas, CA 92024

Mailing address

477 N El Camino Real
C202
Encinitas, CA 92024
Phone (760) 631-3500

Other identifiers 3

IdentifierTypeStateIssuer
WOP10288BMedicaidCA
WOP12300BMedicaidCA
WA92582BMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211001021 CA Part B Supplier - Clinic/Group Practice 5193619021 Receives reassigned benefits from 11 practitioners
Practice locations: Encinitas, CA; Vista, CA

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Solutions2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

477 N El Camino Real
Ste C202
Encinitas, CA 92024
Phone (760) 631-3500

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1467519470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-631-3500",
            "fax_number": "760-753-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-631-3500",
            "fax_number": "760-753-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "DOVENBARGER",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-631-3500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": "A41008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WOP10288B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WOP12300B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WA92582B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.