Individual provider Active NPI

Glenn Kaprielian, OD

  • Optometrist
  • Bakersfield, CA
National Provider Identifier
1679586226
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5707 Issued in CA
Practice address
4649 Planz Rd
Bakersfield, CA 93309-5900
Phone
(661) 833-4040
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5707 CA Primary

Addresses

Primary practice location

4649 Planz Rd
Bakersfield, CA 93309-5900

Mailing address

4649 Planz Rd
Bakersfield, CA 93309-5900
Phone (661) 833-4040

Other identifiers 1

IdentifierTypeStateIssuer
SD0057070MedicaidCA

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
I20160322000556 CA Practitioner - Optometry 1951608728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5707CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Eye Care Optometric Center, Inc Optometrist CurrentSince Jan 1, 2017 Accepting new patients

Locations

4649 Planz Rd
Bakersfield, CA 93309
Phone (661) 833-4040

Organizations & group practices 1

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679586226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4649 PLANZ RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933095900",
            "telephone_number": "661-833-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4649 PLANZ RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933095900",
            "telephone_number": "661-833-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPRIELIAN",
        "first_name": "GLENN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0057070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.