Individual provider Active NPI

Breshna Habibi, OD

  • Optometrist
  • San Ramon, CA
National Provider Identifier
1538984083
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35243 Issued in CA
Practice address
175 Market PL
San Ramon, CA 94583-4741
Phone
(925) 275-0202
NPI assigned
Nov 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35243 CA Primary

Addresses

Primary practice location

175 Market PL
San Ramon, CA 94583-4741

Mailing address

6038 Ledgefern Cir
San Ramon, CA 94582-9187
Phone (925) 502-7164

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
I20241213000607 CA Practitioner - Optometry 7618403650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doris H Wong Optometric CorporationGroup PAC ID 6507095882, 5 clinicians

Practice addresses (Care Compare)

175 Market PL
San Ramon, CA 94583-4741
Phone (925) 275-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Doris H Wong Optometric Corporation Optometrist CurrentSince Dec 3, 2024 Accepting new patients

Locations

175 Market Pl
San Ramon, CA 94583
Phone (925) 275-0202

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": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1538984083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6038 LEDGEFERN CIR",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945829187",
            "telephone_number": "925-502-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MARKET PL",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834741",
            "telephone_number": "925-275-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIBI",
        "first_name": "BRESHNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.