Individual provider Active NPI

Richard Kemp Massengill, M.D.

  • Ophthalmology Physician
  • Encinitas, CA
National Provider Identifier
1649320292
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C37189 Issued in CA
Practice address
664 Hymettus Ave
Encinitas, CA 92024-2603
Phone
(760) 390-1410
Fax
(760) 635-0611
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C37189 CA Primary

Addresses

Primary practice location

664 Hymettus Ave
Encinitas, CA 92024-2603

Mailing address

664 Hymettus Ave
Encinitas, CA 92024-2603
Phone (760) 390-1410

Other identifiers 1

IdentifierTypeStateIssuer
C37189OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C37189CAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1649320292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 HYMETTUS AVE",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242603",
            "telephone_number": "760-390-1410",
            "fax_number": "760-635-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 HYMETTUS AVE",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242603",
            "telephone_number": "760-390-1410",
            "fax_number": "760-635-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGILL",
        "first_name": "RICHARD",
        "middle_name": "KEMP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C37189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C37189",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.