Individual provider Active NPI

Donald Huntley Spaulding, O.D.

  • Optometrist
  • Upland, CA
National Provider Identifier
1467664151
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6810-T Issued in CA
Practice address
944 W Foothill Blvd Ste a
Upland, CA 91786-3757
Phone
(909) 982-3040
Fax
(909) 982-5996
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6810-T CA Primary

Addresses

Primary practice location

944 W Foothill Blvd Ste a
Upland, CA 91786-3757

Mailing address

944 W Foothill Blvd Ste a
Upland, CA 91786-3757
Phone (909) 982-3040

Other identifiers 3

IdentifierTypeStateIssuer
SD 0068100MedicaidCA
SD0068100OtherCAMEDICARE RENDERING #
SD0068101OtherCAMEDICARE PTAN

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
I20080424000340 CA Practitioner - Optometry 3375621881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashmi Patel OD a Professional Optometric CorporationGroup PAC ID 8921411596, 2 clinicians

Practice addresses (Care Compare)

944 W Foothill Blvd
Suite a
Upland, CA 91786-3757
Phone (909) 982-3040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6810-TCAMDOptometrist
6810CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashmi Patel OD a Professional Optometric Corporation Optometrist CurrentSince Jan 1, 2021 Accepting new patients

Locations

944 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (714) 553-3115

Organizations & group practices 1

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1467664151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863757",
            "telephone_number": "909-982-3040",
            "fax_number": "909-982-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "944 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863757",
            "telephone_number": "909-982-3040",
            "fax_number": "909-982-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING",
        "first_name": "DONALD",
        "middle_name": "HUNTLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6810-T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD 0068100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RENDERING #",
            "identifier": "SD0068100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SD0068101",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.