Individual provider Active NPI

Amanda Richards Lakusta, MD

  • Ophthalmology Physician
  • Visalia, CA
National Provider Identifier
1528288669
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C154815 Issued in CA
Practice address
112 N Akers St Ste a
Visalia, CA 93291-5121
Phone
(559) 733-4372
Fax
(559) 733-1758
NPI assigned
Apr 30, 2007
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101254763 VA
Ophthalmology Physician 207W00000X D79626 MD
Ophthalmology Physician 207W00000X C154815 CA Primary

Addresses

Primary practice location

112 N Akers St Ste a
Visalia, CA 93291-5121

Mailing address

112 N Akers St Ste a
Visalia, CA 93291-5121
Phone (559) 733-4372

Other names 1

  • Amanda B Richards Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808000025 CA Practitioner - Ophthalmology 5193964211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Sanford School of Medicine of University of South Dakota, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visalia Eye Center IncGroup PAC ID 0345264222, 3 clinicians

Practice addresses (Care Compare)

112 N Akers St
Suite a
Visalia, CA 93291-5121
Phone (559) 733-4372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C154815CAMDOphthalmology Physician
0101254763VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visalia Eye Center, Inc. Ophthalmology CurrentSince Jan 1, 2024 Accepting new patients
Sentara Hospitals Past Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Kaweah Delta Health Care District PastSince Sep 17, 2018 Accepting new patients
St Marys Hospital of St Marys County Inc Past Accepting new patients

Locations

112 N Akers St
Visalia, CA 93291
Phone (559) 733-4372

112 N Akers St
Ste A
Visalia, CA 93291
Phone (559) 733-4372

Organizations & group practices 5

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": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1528288669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N AKERS ST STE A",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915121",
            "telephone_number": "559-733-4372",
            "fax_number": "559-733-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N AKERS ST STE A",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915121",
            "telephone_number": "559-733-4372",
            "fax_number": "559-733-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKUSTA",
        "first_name": "AMANDA",
        "middle_name": "RICHARDS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101254763",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D79626",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C154815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "RICHARDS",
            "middle_name": "B",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.