Individual provider Active NPI

Ayesha Priti Burns, O.D.

  • Optometrist
  • Santa Cruz, CA
National Provider Identifier
1629224605
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13611 Issued in CA
Practice address
550 Water St Ste J5
Santa Cruz, CA 95060-4135
Phone
(831) 426-7172
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13611 CA Primary

Addresses

Primary practice location

550 Water St Ste J5
Santa Cruz, CA 95060-4135

Mailing address

550 Water St Ste J5
Santa Cruz, CA 95060-4135
Phone (831) 426-7172

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
I20081210000007 CA Practitioner - Optometry 6901967918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Craig Fellers OD IncGroup PAC ID 0345568184, 3 clinicians

Practice addresses (Care Compare)

550 Water St
Suite J5
Santa Cruz, CA 95060-4135
Phone (831) 426-7172

550 Water St St
J5
Santa Cruz, CA 95060-4135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Fellers OD Inc Optometrist CurrentSince Jan 17, 2015 Accepting new patients
John a Van Every OD Optometrist PastSince Aug 1, 2013 Accepting new patients

Locations

550 Water St
Ste J5
Santa Cruz, CA 95060
Phone (831) 426-7172

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": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1629224605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WATER ST STE J5",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604135",
            "telephone_number": "831-426-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WATER ST STE J5",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604135",
            "telephone_number": "831-426-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "AYESHA",
        "middle_name": "PRITI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.