Brent Kenji Mitsuuchi, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10380T Issued in CA

Practice address

1280 S Victoria Ave Ste 100
Ventura, CA 93003-6550

Phone

(805) 650-9922

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Southern California College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ventura Optometric Vision Care Inc.Group PAC ID 8820045636, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ventura Optometric Vision Care Inc.

  • Optometrist
  • Ventura, CA
  • NPI 1619935103
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1649300310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 S VICTORIA AVE STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036550",
            "telephone_number": "805-650-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 S VICTORIA AVE STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036550",
            "telephone_number": "805-650-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSUUCHI",
        "first_name": "BRENT",
        "middle_name": "KENJI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10380T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES INS#",
            "identifier": "2371",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine D Mistry
• Bryan Mitchell
• James F Mitchell Jr., MD
• Michael Hewitt Mitchell, MD
• Nicole Anais Mitchell, CATC III
• Debra Miyasaki
• Alejandro Guillermo Mizraji, D.D.S.
• MNS Medical Associates
• Mobility Collective Physical Therapy and Wellness Inc
• Anastasia Mobley Tobias

• Optometrist in Ventura, CA
• Providers in Ventura, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.