Individual provider Active NPI

Michael Anthony Santarlas, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1548379613
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13241TLG Issued in CA
Practice address
221 Island Ave Unit 503
San Diego, CA 92101-6898
Phone
(199) 953-9376
NPI assigned
Aug 30, 2006
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13241TLG CA Primary
Corneal and Contact Management Optometrist 152WC0802X 046009527 IL

Addresses

Primary practice location

221 Island Ave Unit 503
San Diego, CA 92101-6898

Mailing address

221 Island Ave Unit 503
San Diego, CA 92101-6898
Phone (199) 953-9376

Other practice location 1

1205 W Ferdon St
Litchfield, IL 62056-4444
Phone (217) 324-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210709000171 TX Practitioner - Optometry 8921062449 Reassigns benefits to 3 organizations
I20220706001534 CA Practitioner - Optometry 8921062449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13241TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix CurrentSince Nov 5, 2021 Accepting new patients
DHHS PHS IHS Phoenix Area CurrentSince May 23, 2021 Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients
Total Vision PC Optometrist CurrentSince Mar 24, 2022 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jan 22, 2022 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Jan 22, 2022 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients

Locations

12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137

7850 Broadway
Lemon Grove, CA 91945
Phone (619) 697-2020

27271 Las Ramblas
Ste 200
Mission Viejo, CA 92691
Phone (949) 651-7236

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

3750 Sports Arena Blvd
Ste 9
San Diego, CA 92110
Phone (619) 224-2879

401 Picacho Rd
Winterhaven, CA 92283
Phone (760) 572-4100

4100 W 150th St
Cleveland, OH 44135

Organizations & group practices 7

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1548379613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 ISLAND AVE UNIT 503",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016898",
            "telephone_number": "199-953-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 ISLAND AVE UNIT 503",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016898",
            "telephone_number": "199-953-9376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 W Ferdon St",
            "address_purpose": "LOCATION",
            "city": "Litchfield",
            "state": "IL",
            "postal_code": "620564444",
            "country_code": "US",
            "telephone_number": "217-324-5005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTARLAS",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13241TLG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046009527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.