Individual provider Active NPI

Lynette Marie Cacciotti, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1578619151
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7149T Issued in CA
Practice address
10940 Santa Monica Blvd
Los Angeles, CA 90025-4539
Phone
(310) 966-5030
Fax
(310) 966-9369
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7149T CA Primary

Addresses

Primary practice location

10940 Santa Monica Blvd
Los Angeles, CA 90025-4539

Mailing address

10940 Santa Monica Blvd
Los Angeles, CA 90025-4539
Phone (310) 966-5030

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
I20120613000255 CA Practitioner - Optometry 0749498665 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10940 Santa Monica Blvd
Los Angeles, CA 90025-4539
Phone (310) 966-5030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7149TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr C Optometry Optometrist CurrentSince Jul 1, 1995 Accepting new patients

Locations

10940 Santa Monica Blvd
Los Angeles, CA 90025
Phone (310) 966-5030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1578619151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10940 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254539",
            "telephone_number": "310-966-5030",
            "fax_number": "310-966-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10940 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254539",
            "telephone_number": "310-966-5030",
            "fax_number": "310-966-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCIOTTI",
        "first_name": "LYNETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7149T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.