Individual provider Active NPI

Leonard H Forbes, O.D.

  • Optometrist
  • Sylmar, CA
National Provider Identifier
1497867600
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT4873TPA Issued in CA
Practice address
12737 Glenoaks Blvd
Suite 3
Sylmar, CA 91342-4724
Phone
(818) 367-1015
Fax
(818) 367-3593
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT4873TPA CA Primary

Addresses

Primary practice location

12737 Glenoaks Blvd
Suite 3
Sylmar, CA 91342-4724

Mailing address

12737 Glenoaks Blvd
Suite 3
Sylmar, CA 91342-4724
Phone (818) 367-1015

Other identifiers 1

IdentifierTypeStateIssuer
1497867600MedicaidCA

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
I20080609000885 CA Practitioner - Optometry 8224108725 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Sylmar, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT4873TPACAMDOptometrist
4873CAMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Vision Center an Optometric Practice Incorporated Optometrist CurrentSince Jun 1, 2000 Accepting new patients
Ellen Shuham OD Inc Optometrist PastSince Jun 1, 2000 Accepting new patients
Dr. Leonard H. Forbes, O.D. Optometrist PastSince Jan 1, 1990 Accepting new patients

Locations

26506 Bouquet Canyon Rd
Saugus, CA 91350
Phone (661) 297-2020

Interoperability endpoints

  • Direct secure messaging: leonard.forbes@uprisedirect.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1497867600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12737 GLENOAKS BLVD",
            "address_2": "SUITE 3",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424724",
            "telephone_number": "818-367-1015",
            "fax_number": "818-367-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12737 GLENOAKS BLVD",
            "address_2": "SUITE 3",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424724",
            "telephone_number": "818-367-1015",
            "fax_number": "818-367-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "LEONARD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT4873TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497867600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.