Individual provider Active NPI

Scott Holbert, O.D.

  • Optometrist
  • Santa Clara, CA
National Provider Identifier
1639503923
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14757 Issued in CA
Practice address
2855 Stevens Creek Blvd
Ste 1151
Santa Clara, CA 95050-6717
Phone
(408) 243-9394
NPI assigned
Aug 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14757 CA Primary

Addresses

Primary practice location

2855 Stevens Creek Blvd
Ste 1151
Santa Clara, CA 95050-6717

Mailing address

2855 Stevens Creek Blvd
Ste 1151
Santa Clara, CA 95050-6717
Phone (408) 489-4790

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
I20140609002118 CA Practitioner - Optometry 5597989798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14757CAMDAcupuncturist

Organizations & group practices 1

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": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1639503923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 STEVENS CREEK BLVD",
            "address_2": "STE 1151",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506717",
            "telephone_number": "408-489-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 STEVENS CREEK BLVD",
            "address_2": "STE 1151",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506717",
            "telephone_number": "408-243-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBERT",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.