Individual provider Active NPI

Richard Garratt, O.D.

  • Optometrist
  • San Dimas, CA
National Provider Identifier
1598813800
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 8364 TPA Issued in CA
Practice address
120 W Bonita Ave
Suite a
San Dimas, CA 91773-3085
Phone
(909) 599-1100
Fax
(909) 394-1743
NPI assigned
Jan 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 8364 TPA CA Primary

Addresses

Primary practice location

120 W Bonita Ave
Suite a
San Dimas, CA 91773-3085

Mailing address

120 W Bonita Ave
Suite a
San Dimas, CA 91773-3085
Phone (909) 599-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 8364 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Suzan Burmayan, O.D., a Professional Corporation Optometrist PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 2

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598813800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W BONITA AVE",
            "address_2": "SUITE A",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733085",
            "telephone_number": "909-599-1100",
            "fax_number": "909-394-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W BONITA AVE",
            "address_2": "SUITE A",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733085",
            "telephone_number": "909-599-1100",
            "fax_number": "909-394-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRATT",
        "first_name": "RICHARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 8364 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.