Individual provider Active NPI

Shannon Olario Alturas, O.D.

  • Optometrist
  • West Covina, CA
National Provider Identifier
1609095090
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12898T Issued in CA
Practice address
3658 S Nogales St
West Covina, CA 91792-2714
Phone
(626) 539-3543
NPI assigned
Apr 24, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12898T CA Primary

Addresses

Primary practice location

3658 S Nogales St
West Covina, CA 91792-2714

Mailing address

3658 S Nogales St
West Covina, CA 91792-2714
Phone (626) 539-3543

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
I20051215000864 CA Practitioner - Optometry 9638190762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarion Optometry Group Prof CorpGroup PAC ID 0042538464, 4 clinicians

Practice addresses (Care Compare)

3658 S Nogales St
West Covina, CA 91792-2714
Phone (626) 461-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12898TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarion Optometry Group Prof Corp Optometrist CurrentSince Nov 30, 2020 Accepting new patients
Dena M. Mintz, O.D., a Professional Corporation Optometrist PastSince Oct 18, 2006 Accepting new patients
Alan Arabi O.D., Inc Optometrist PastSince Apr 23, 2016 Accepting new patients

Locations

3658 S Nogales St
West Covina, CA 91792
Phone (626) 461-7300

56970 Yucca Trl
Ste 101
Yucca Valley, CA 92284
Phone (760) 228-2020

Organizations & group practices 4

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1609095090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3658 S NOGALES ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922714",
            "telephone_number": "626-539-3543",
            "fax_number": "866-597-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3658 S NOGALES ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922714",
            "telephone_number": "626-539-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTURAS",
        "first_name": "SHANNON",
        "middle_name": "OLARIO",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12898T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.