Active NPI
Phillip Polster, OD
- Optometrist
- Porterville, CA
National Provider Identifier
1528162823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- CAOPT5319TPA
- Practice address
- 1250 W Henderson Ave
Porterville, CA 93257 - Phone
- (559) 783-8277
- NPI assigned
- Sep 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | CAOPT5319TPA | CA | Primary |
Addresses
Primary practice location
1250 W Henderson Ave
Porterville, CA 93257
Mailing address
1250 W Henderson Ave
Porterville, CA 93257
Phone (559) 783-8277
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0053190 | Medicaid | CA | |
| 03275 | Other | CA | SPECTERA |
| 48737 | Other | CA | SAFEGUARD PPO |
| 086510 | Other | CA | HEALTH NET |
| 47023 | Other | CA | SAFEGUARD HMO |
| 6199 | Other | CA | MEDICAL EYE SERVICES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CAOPT5319TPA | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528162823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 W HENDERSON AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "93257",
"telephone_number": "559-783-8277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 W HENDERSON AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "93257",
"telephone_number": "559-783-8277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSTER",
"first_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "CAOPT5319TPA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0053190",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "03275",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAFEGUARD PPO",
"identifier": "48737",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "086510",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAFEGUARD HMO",
"identifier": "47023",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES",
"identifier": "6199",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Porterville, CA
- Rudolph D Pina, SUD COUNSELOR
- Pioneer Home Outreach, Inc.
- Jonathan Plascencia
- Pleasant View Elementary School District
- Cleon Plummer, DDS
- Sherlyn Ricablanca Porter, PPS., LCSW
- Porterville Adult Day Health Care
- Porterville Community Physicians Inc
- Porterville Convalescent, Inc. (Porterville Convalescent Hospital)
- Porterville Express Specialty Pharmacy, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.