Individual provider Active NPI

Brandon Jay Friedman, O.D.

  • Optometrist
  • San Bernardino, CA
National Provider Identifier
1619288115
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13943 Issued in CA
Practice address
2150 N Waterman Ave
Suite 201
San Bernardino, CA 92404-4811
Phone
(909) 881-2020
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13943 CA Primary

Addresses

Primary practice location

2150 N Waterman Ave
Suite 201
San Bernardino, CA 92404-4811

Mailing address

2150 N Waterman Ave
Suite 201
San Bernardino, CA 92404-4811
Phone (909) 881-2020

Other identifiers 1

IdentifierTypeStateIssuer
1619288115MedicaidCA

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
I20100910000921 CA Practitioner - Optometry 4789709973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2150 N Waterman Ave
Suite 201
San Bernardino, CA 92404-4811
Phone (909) 881-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13943CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arthur Friedman OD Apoc Optometrist Current Accepting new patients
Arthur Friedman OD a Professional Optometric Corporation Optometrist CurrentSince Jul 1, 2010 Accepting new patients

Locations

7890 Haven Ave
Ste 17
Rch Cucamonga, CA 91730
Phone (909) 987-3330

10837 Laurel St
Ste 202
Rch Cucamonga, CA 91730
Phone (909) 945-2425

2150 N Waterman Ave
Ste 201
Sn Bernrdno, CA 92404
Phone (909) 717-9636

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1619288115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "SUITE 201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "909-881-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "SUITE 201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "909-881-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "BRANDON",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619288115",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.