Michael D Magdato OD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MICHAEL D MAGDATO OD

Practice address

5237 Arrow Hwy
Montclair, CA 91763-1308

Phone

(909) 625-6567

NPI assigned

Oct 30, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Michael D Magdato, ODNPI 1942226022

Title

Owner

Phone

(714) 651-6987

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Montclair Optometric Center Doing business as

Practitioners 1

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

• Michael D Magdato, O.D.

  • Optometrist
  • Montclair, CA
  • NPI 1942226022
  NPD Authorized official

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1689274433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5237 ARROW HWY",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631308",
            "telephone_number": "909-625-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5237 ARROW HWY",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631308",
            "telephone_number": "909-625-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D MAGDATO OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "MAGDATO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-651-6987",
        "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": "5700641",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montclair Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Montclair, CA
• Providers in Montclair, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.