Organization Active NPI

See Clear Optometry a Professional Corporation

  • Optometrist
  • Pasadena, CA
National Provider Identifier
1679117196
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SEE CLEAR OPTOMETRY A PROFESSIONAL CORPORATION
Practice address
3235 E Colorado Blvd
Suite 101
Pasadena, CA 91107
Phone
(626) 765-6634
Fax
(626) 765-6722
NPI assigned
Oct 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Dr. Lourice Boutros, ODNPI 1083109904
Title
Owner/President
Phone
(626) 765-6634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3235 E Colorado Blvd
Suite 101
Pasadena, CA 91107

Mailing address

3235 E Colorado Blvd
Suite 101
Pasadena, CA 91107
Phone (626) 765-6634

Other identifiers 1

IdentifierTypeStateIssuer
NONEMedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL seeclearoptometry@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219002697 CA Part B Supplier - Clinic/Group Practice 8325475999 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory

Locations

3235 E Colorado Blvd
Ste 101
Pasadena, CA 91107
Phone (626) 765-6634

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1679117196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 E COLORADO BLVD",
            "address_2": "SUITE 101",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-765-6634",
            "fax_number": "626-765-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 E COLORADO BLVD",
            "address_2": "SUITE 101",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-765-6634",
            "fax_number": "626-765-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEE CLEAR OPTOMETRY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "LOURICE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "626-765-6634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "seeclearoptometry@gmail.com",
            "affiliation": "N",
            "address_1": "3235 E Colorado Blvd Ste 101",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "911073837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.