NPIMap

Organization Active NPI

Ventura Optometric Vision Care Inc.

  • Optometrist
  • Ventura, CA
National Provider Identifier
1619935103
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VENTURA OPTOMETRIC VISION CARE INC.
Practice address
1280 S Victoria Ave
Suite 100
Ventura, CA 93003-6555
Phone
(805) 650-9922
Fax
(805) 650-6656
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Authorized official

Name
Dr. Brent K. Mitsuuchi, O.D.NPI 1649300310
Title
Secretary
Phone
(805) 650-9922

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
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1280 S Victoria Ave
Suite 100
Ventura, CA 93003-6555

Mailing address

1280 S Victoria Ave
Suite 100
Ventura, CA 93003-6555
Phone (805) 650-9922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050404001142 CA Part B Supplier - Clinic/Group Practice 8820045636 Receives reassigned benefits from 8 practitioners
Practice locations: Ventura, CA

National Provider Directory

National Provider Directory

Locations

1280 S Victoria Ave
Ste 100
Ventura, CA 93003
Phone (805) 650-9922

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1619935103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 S VICTORIA AVE",
            "address_2": "SUITE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036555",
            "telephone_number": "805-650-9922",
            "fax_number": "805-650-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 S VICTORIA AVE",
            "address_2": "SUITE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036555",
            "telephone_number": "805-650-9922",
            "fax_number": "805-650-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTURA OPTOMETRIC VISION CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "MITSUUCHI",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "805-650-9922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.