Active NPI
Kathleen Beuttler, M.D.
- Ophthalmology Physician
- Ventura, CA
National Provider Identifier
1669416103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- C41709
- Practice address
- 3085 Loma Vista Rd
Ventura, CA 93003-2916 - Phone
- (805) 648-3085
- Fax
- (805) 648-7027
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | C41709 | CA | Primary |
Addresses
Primary practice location
3085 Loma Vista Rd
Ventura, CA 93003-2916
Mailing address
3085 Loma Vista Rd
Ventura, CA 93003-2916
Phone (805) 648-3085
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WC41709B | Other | CA | DMERC |
| 205153800 | Other | CA | US DEPT. OF LABOR |
| C417090 | Other | CA | BLUE SHIELD |
| 180036165 | Other | CA | RAILROAD MEDICARE |
| C417090 | Other | CA | CHAMPUS |
| GR0076890 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C41709 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1669416103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3085 LOMA VISTA RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930032916",
"telephone_number": "805-648-3085",
"fax_number": "805-648-7027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3085 LOMA VISTA RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930032916",
"telephone_number": "805-648-3085",
"fax_number": "805-648-7027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEUTTLER",
"first_name": "KATHLEEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "C41709",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "WC41709B",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT. OF LABOR",
"identifier": "205153800",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "C417090",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180036165",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "C417090",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0076890",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.