Individual provider Active NPI

Atousa Attar, O.D.

  • Optometrist
  • Mission Viejo, CA
National Provider Identifier
1689619512
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT12544 Issued in CA
Practice address
300 The Shops Blvd
Mission Viejo, CA 92691-9269
Phone
(949) 347-1287
Fax
(949) 347-1256
NPI assigned
Jun 17, 2006
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT12544 CA Primary

Addresses

Primary practice location

300 The Shops Blvd
Mission Viejo, CA 92691-9269

Mailing address

3085 Loma Vista Rd
Ventura, CA 93003-2916
Phone (805) 648-3085

Other practice location 1

3085 Loma Vista Rd
Ventura, CA 93003-2916
Phone (805) 648-3085

Other identifiers 1

IdentifierTypeStateIssuer
205153800OtherCAUS DEPT. OF LABOR

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
I20050506000739 CA Practitioner - Optometry 9032159272 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
George M. Salib, MD Inc.Group PAC ID 7012192586, 3 clinicians
Aa Optometric Group IncGroup PAC ID 8224404140, 3 clinicians

Practice addresses (Care Compare)

24422 Avenida de la Carlota
Suite 110
Laguna Hills, CA 92653-3634
Phone (949) 770-1322

3500 S Bristol St
Suite 202
Santa Ana, CA 92704-7306
Phone (714) 557-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12544CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
George M. Salib, M.D. Inc. CurrentSince Jan 11, 2023 Accepting new patients
Atousa Attar OD Inc Optometrist CurrentSince Aug 24, 2022 Accepting new patients
Miramar Lynn Medical Group Inc Past Accepting new patients
Neda Rashti, O.D., Inc. Optometrist PastSince Jul 4, 2021 Accepting new patients
Jimmy K. Lee, M.D. Inc. Past Accepting new patients
Debra G Tennen, MD, a Professional Medical Corporation PastSince Jul 1, 2003 Accepting new patients

Locations

24422 Avenida de la Carlota
Ste 110
Laguna Hills, CA 92653
Phone (949) 770-1322

3500 S Bristol St
Ste 202
Santa Ana, CA 92704
Phone (714) 557-7800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1689619512",
    "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": "300 THE SHOPS BLVD",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926919269",
            "telephone_number": "949-347-1287",
            "fax_number": "949-347-1256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3085 Loma Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930032916",
            "country_code": "US",
            "telephone_number": "805-648-3085",
            "fax_number": "805-648-7027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATTAR",
        "first_name": "ATOUSA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-07-01",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT. OF LABOR",
            "identifier": "205153800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.