Individual provider Active NPI

Robert James Okamura, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1508894429
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05919-T Issued in CA
Practice address
1947 Fern St
San Diego, CA 92102-1137
Phone
(619) 233-6183
Fax
(619) 232-7415
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 05919-T CA Primary

Addresses

Primary practice location

1947 Fern St
San Diego, CA 92102-1137

Mailing address

1947 Fern St
San Diego, CA 92102-1137
Phone (619) 233-6183

Other identifiers 2

IdentifierTypeStateIssuer
OP5919OtherCAPTAN / MEDICARE NUMBER
SD0059190MedicaidCA

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

LicenseStateTypeSpecialty
05919-TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Fitzpatrick Inc Optometrist PastSince May 7, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1508894429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1947 FERN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021137",
            "telephone_number": "619-233-6183",
            "fax_number": "619-232-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 FERN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021137",
            "telephone_number": "619-233-6183",
            "fax_number": "619-232-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAMURA",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "05919-T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN / MEDICARE NUMBER",
            "identifier": "OP5919",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0059190",
            "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 Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.