Individual provider Active NPI

Michael G Buffo, O.D.

  • Optometrist
  • Camarillo, CA
National Provider Identifier
1649347337
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9211T Issued in CA
Practice address
2316 Ventura Blvd
Camarillo, CA 93010-6653
Phone
(805) 482-1299
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9211T CA Primary
Corneal and Contact Management Optometrist 152WC0802X 9211T CA
Occupational Vision Optometrist 152WX0102X 9211T CA

Addresses

Primary practice location

2316 Ventura Blvd
Camarillo, CA 93010-6653

Mailing address

2316 Ventura Blvd
Camarillo, CA 93010-6653
Phone (805) 482-1299

Other identifiers 6

IdentifierTypeStateIssuer
44059OtherCADAVIS VISION
BO24396OtherCASPECTERA
CA9211OtherCAEYEMED
200544192OtherCATRICARE
16361OtherCAMEDICAL EYE SERVICES
8053889500OtherCAVSP

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
I20040621001984 CA Practitioner - Optometry 9931184256 Practice locations: Camarillo, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2316 E Ventura Blvd
Camarillo, CA 93010-6653
Phone (805) 388-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9211TCAMDOccupational Vision Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223856000000",
    "number": "1649347337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106653",
            "telephone_number": "805-482-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106653",
            "telephone_number": "805-482-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFFO",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9211T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "9211T",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "9211T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "44059",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "BO24396",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "CA9211",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "200544192",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "16361",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "8053889500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.