Organization Active NPI

Northwest Optometry Associates, Inc.

  • Optometrist
  • Fresno, CA
National Provider Identifier
1578656278
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10526T Issued in CA
Legal business name
NORTHWEST OPTOMETRY ASSOCIATES, INC.
Practice address
7355 N Palm Ave Ste 109
Fresno, CA 93711-5770
Phone
(559) 225-2020
Fax
(559) 227-6411
NPI assigned
Oct 2, 2006
Last updated
Jun 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Dr. Amanda R. Schmidt, O.D.NPI 1578555108
Title
Optometrist Owner
Phone
(559) 225-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10526T CA Primary

Addresses

Primary practice location

7355 N Palm Ave Ste 109
Fresno, CA 93711-5770

Mailing address

7355 N Palm Ave Ste 109
Fresno, CA 93711-5770
Phone (559) 225-2020

Other identifiers 1

IdentifierTypeStateIssuer
9703435MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040914001296 CA Part B Supplier - Clinic/Group Practice 6002883469 Receives reassigned benefits from 1 practitioner
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Locations

1284 W Shaw Ave
Ste 105
Fresno, CA 93711
Phone (209) 222-7622

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1578656278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 N PALM AVE STE 109",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115770",
            "telephone_number": "559-225-2020",
            "fax_number": "559-227-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 N PALM AVE STE 109",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115770",
            "telephone_number": "559-225-2020",
            "fax_number": "559-227-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OPTOMETRY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "559-225-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10526T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9703435",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.