Individual provider Active NPI

Emmanuel Dela Cruz II, O.D.

  • Optometrist
  • Mountain View, CA
National Provider Identifier
1508179706
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13964 Issued in CA
Practice address
1898 W El Camino Real
Mountain View, CA 94040-2356
Phone
(650) 961-2926
Fax
(650) 961-2890
NPI assigned
Jul 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13964 CA Primary

Addresses

Primary practice location

1898 W El Camino Real
Mountain View, CA 94040-2356

Mailing address

43955 S Moray St
Fremont, CA 94539-5942
Phone (408) 360-9312

Other practice location 1

5411 Thornwood Dr
San Jose, CA 95123-1215
Phone (408) 360-9312

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
I20110906000086 CA Practitioner - Optometry 1052581824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DCHS Medical Foundation CurrentSince Jun 16, 2014 Accepting new patients
Verity Medical Foundation CurrentSince Jun 16, 2014 Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Pearle Visioncare, Inc Past Accepting new patients

Locations

25455 Medical Center Dr
Ste 200
Murrieta, CA 92562
Phone (951) 894-7056

625 Lincoln Ave
San Jose, CA 95126
Phone (408) 278-3003

Organizations & group practices 4

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1508179706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43955 S MORAY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395942",
            "telephone_number": "408-360-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 W EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402356",
            "telephone_number": "650-961-2926",
            "fax_number": "650-961-2890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5411 Thornwood Dr",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951231215",
            "country_code": "US",
            "telephone_number": "408-360-9312",
            "fax_number": "408-360-9314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.