Individual provider Active NPI

Suzan Burmayan, OD

  • Optometrist
  • San Dimas, CA
National Provider Identifier
1619498078
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33687 Issued in CA
Practice address
120 W Bonita Ave Ste a
San Dimas, CA 91773-5000
Phone
(909) 599-1100
Fax
(909) 394-1743
NPI assigned
Jul 6, 2017
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33687 CA Primary

Addresses

Primary practice location

120 W Bonita Ave Ste a
San Dimas, CA 91773-5000

Mailing address

120 W Bonita Ave Ste a
San Dimas, CA 91773-5000
Phone (909) 599-1100

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
I20180202001174 CA Practitioner - Optometry 6901166396 Reassigns benefits to 1 organization
Practice locations: Northridge, CA; West Covina, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suzan Burmayan OD a Professional CorporationGroup PAC ID 1456891712, 2 clinicians

Practice addresses (Care Compare)

120 W Bonita Ave
Suite a
San Dimas, CA 91773-5000
Phone (909) 599-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT33687CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Suzan Burmayan, O.D., a Professional Corporation Optometrist CurrentSince Jul 24, 2024 Accepting new patients
Richard Garratt OD Inc Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Clarion Optometry Group Prof Corp Optometrist CurrentSince Jan 1, 2021 Accepting new patients
Linden Optometry a Professional Corporation Optometrist PastSince Mar 1, 1999 Accepting new patients
Shannon O. Alturas, O.D., a Professional Corporation Optometrist PastSince Jul 9, 2013 Accepting new patients
Kathy Chriqui a Professional Optometric Corporation Optometrist PastSince Jan 1, 2004 Accepting new patients

Locations

120 W Bonita Ave
Ste A
San Dimas, CA 91773
Phone (909) 599-1100

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 6

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1619498078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W BONITA AVE STE A",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917735000",
            "telephone_number": "909-599-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W BONITA AVE STE A",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917735000",
            "telephone_number": "909-599-1100",
            "fax_number": "909-394-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURMAYAN",
        "first_name": "SUZAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.