Individual provider Active NPI

Douglas Wayne Stephey, OD,

  • Optometrist
  • Covina, CA
National Provider Identifier
1649290123
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
08594 Issued in CA
Practice address
208 W Badillo St
Covina, CA 91723-1906
Phone
(626) 332-4510
Fax
(626) 332-2630
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 08594 CA Primary

Addresses

Primary practice location

208 W Badillo St
Covina, CA 91723-1906

Mailing address

208 W Badillo St
Covina, CA 91723-1906
Phone (626) 332-4510

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
I20100618000344 CA Practitioner - Optometry 2264562164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 W Badillo St
Covina, CA 91723-1906
Phone (626) 332-4510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08594CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas W Stephey OD Inc Optometrist CurrentSince Feb 10, 2010 Accepting new patients

Locations

208 W Badillo St
Covina, CA 91723
Phone (626) 332-4510

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1649290123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231906",
            "telephone_number": "626-332-4510",
            "fax_number": "626-332-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231906",
            "telephone_number": "626-332-4510",
            "fax_number": "626-332-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEY",
        "first_name": "DOUGLAS",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "OD,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "08594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.