Individual provider Active NPI

Anthony P Giannotti, OD

  • Optometrist
  • Scotts Valley, CA
National Provider Identifier
1669446522
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6667 TLG Issued in CA
Practice address
221 Mount Hermon Rd
Suite G
Scotts Valley, CA 95066-4038
Phone
(831) 438-4482
Fax
(831) 438-7360
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6667 TLG CA Primary

Addresses

Primary practice location

221 Mount Hermon Rd
Suite G
Scotts Valley, CA 95066-4038

Mailing address

221 Mount Hermon Rd
Suite G
Scotts Valley, CA 95066-4038
Phone (831) 438-4482

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
I20120611000382 CA Practitioner - Optometry 4688784556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anthony P. Giannotti OD Professional Optometric CorpGroup PAC ID 2365569811, 2 clinicians

Practice addresses (Care Compare)

221 Mount Hermon Rd
Suite G
Scotts Valley, CA 95066-4038
Phone (831) 438-4482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6667 TLGCAMDOptometrist
6667CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony P. Giannotti OD Professional Optometric Corp Optometrist CurrentSince Sep 5, 1979 Accepting new patients
Harvey a. Fishman, M.D., a Professional Corporation Past Accepting new patients

Locations

266 Mount Hermon Rd
Ste O
Scotts Valley, CA 95066
Phone (408) 438-4482

221 Mount Hermon Rd
Ste G
Scotts Valley, CA 95066
Phone (831) 438-4482

Organizations & group practices 2

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1669446522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MOUNT HERMON RD",
            "address_2": "SUITE G",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664038",
            "telephone_number": "831-438-4482",
            "fax_number": "831-438-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MOUNT HERMON RD",
            "address_2": "SUITE G",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664038",
            "telephone_number": "831-438-4482",
            "fax_number": "831-438-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANNOTTI",
        "first_name": "ANTHONY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6667 TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotts Valley, CA

Sources for this page

Verify at the official NPI Registry.