Active NPI
Mark James Delsman
- Optometrist
- San Diego, CA
National Provider Identifier
1497712871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7444T
- Practice address
- 3068 University Ave
San Diego, CA 92104-3034 - Phone
- (619) 298-5524
- Fax
- (619) 298-7175
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7444T | CA | Primary |
Addresses
Primary practice location
3068 University Ave
San Diego, CA 92104-3034
Mailing address
3068 University Ave
San Diego, CA 92104-3034
Phone (619) 298-5524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GSD001540 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7444T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heights Optometry | Optometrist | Past | Accepting new patients |
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.
-
- Optometrist
- San Diego, CA
- NPI 1386034163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462233600000",
"number": "1497712871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3068 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921043034",
"telephone_number": "619-298-5524",
"fax_number": "619-298-7175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3068 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921043034",
"telephone_number": "619-298-5524",
"fax_number": "619-298-7175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELSMAN",
"first_name": "MARK",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2016-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7444T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GSD001540",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.