Individual provider Active NPI

Peter S. Visendi, O.D.

  • Optometrist
  • Danville, CA
National Provider Identifier
1518029693
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5475T Issued in CA
Practice address
3464 Camino Tassajara
Danville, CA 94506-4680
Phone
(925) 736-4911
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5475T CA Primary

Addresses

Primary practice location

3464 Camino Tassajara
Danville, CA 94506-4680

Mailing address

3464 Camino Tassajara
Danville, CA 94506-4680
Phone (925) 736-4911

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
I20040929000709 CA Practitioner - Optometry 3072582766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danville Optometric Eye ClinicGroup PAC ID 4082035472, 2 clinicians

Practice addresses (Care Compare)

3464 Camino Tassajara
Danville, CA 94506-4680
Phone (925) 736-4911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5475TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Optometric Eye Clinic CurrentSince Jun 1, 2020 Accepting new patients
Michael W Ottati, Jr., O.D. Inc Optometrist PastSince Jan 11, 2008 Accepting new patients

Locations

3464 Camino Tassajara
Danville, CA 94506
Phone (925) 736-4911

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1518029693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 CAMINO TASSAJARA",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064680",
            "telephone_number": "925-736-4911",
            "fax_number": "925-736-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 CAMINO TASSAJARA",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064680",
            "telephone_number": "925-736-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISENDI",
        "first_name": "PETER",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5475T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

Verify at the official NPI Registry.