Danita Lai, O.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

8019 TPL Issued in CA

Practice address

28222 Agoura Rd Ste 400
Agoura Hills, CA 91301-2411

Phone

(818) 597-0070

Fax

(818) 597-0278

NPI assigned

Feb 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Danita Sam Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1497721427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28222 AGOURA RD STE 400",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012411",
            "telephone_number": "818-597-0070",
            "fax_number": "818-597-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28222 AGOURA RD STE 400",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012411",
            "telephone_number": "818-597-0070",
            "fax_number": "818-597-0278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6800 Owensmouth Ave",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Canoga Park",
            "state": "CA",
            "postal_code": "913033159",
            "country_code": "US",
            "telephone_number": "818-340-5796",
            "fax_number": "818-340-4030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAI",
        "first_name": "DANITA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8019TLG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "8019 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN#",
            "identifier": "0380900002",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0080190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANITA",
            "last_name": "SAM",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Vision Therapy Optometrist in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Vision Therapy Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.