Individual provider Active NPI

Sheena Ansarinia, OD

  • Optometrist
  • Costa Mesa, CA
National Provider Identifier
1639726680
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34460 Issued in CA
Practice address
1545 Adams Ave Ste 100
Costa Mesa, CA 92626-3875
Phone
(714) 545-9162
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT-002381 AZ
Optometrist 152W00000X 34460 CA Primary

Addresses

Primary practice location

1545 Adams Ave Ste 100
Costa Mesa, CA 92626-3875

Mailing address

1545 Adams Ave Ste 100
Costa Mesa, CA 92626-3875

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
I20200914002528 CA Practitioner - Optometry 3173953064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34460CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Eye Care Centers a Comp Ophthalmology Medical GRP Inc. Single Specialty CurrentSince Aug 1, 2022 Accepting new patients

Locations

31852 Coast Hwy
Ste 101
Laguna Beach, CA 92651
Phone (714) 588-2020

24022 Calle de la Plata
Ste 305
Laguna Hills, CA 92653
Phone (949) 588-2020

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1639726680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 ADAMS AVE STE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ADAMS AVE STE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263875",
            "telephone_number": "714-545-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARINIA",
        "first_name": "SHEENA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002381",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.