Individual provider Active NPI

Sydni Glass, OD

  • Optometrist
  • Lancaster, CA
National Provider Identifier
1497275689
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34106 Issued in CA
Practice address
44815 Fig Ave
Lancaster, CA 93534-3144
Phone
(661) 206-8469
Fax
(661) 206-8924
NPI assigned
Jun 20, 2017
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2587 MD
Optometrist 152W00000X 34106 CA Primary

Addresses

Primary practice location

44815 Fig Ave
Lancaster, CA 93534-3144

Mailing address

100 E California Blvd
Pasadena, CA 91105-3205
Phone (626) 689-2124

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20181221002097 CA Practitioner - Optometry 5395017099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

43112 15TH St W
Lancaster, CA 93534-6219
Phone (661) 726-2378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2024 Accepting new patients
Telahun, Shrader & Rivera, MD CurrentSince Jun 28, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Michigan Glaucoma & Cataract, P.C. PastSince Jun 28, 2017 Accepting new patients
Lori P. Alexander, MSPT, LLC PastSince Nov 29, 2011 Accepting new patients

Locations

11525 Brookshire Ave
Downey, CA 90241
Phone (562) 861-0954

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2930

9131 Piscataway Rd
Ste 450
Clinton, MD 20735
Phone (301) 868-6700

127 N Washington St
Ste A
Alexandria, VA 22314
Phone (301) 868-6700

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1497275689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053205",
            "telephone_number": "626-689-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44815 FIG AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343144",
            "telephone_number": "661-206-8469",
            "fax_number": "661-206-8924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "SYDNI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2587",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.