Individual provider Active NPI

James L Cooperman, OD

  • Optometrist
  • Fountain Valley, CA
National Provider Identifier
1689639429
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7875T Issued in CA
Practice address
18449 Brookhurst St
Ste 6
Fountain Valley, CA 92708-6751
Phone
(714) 963-2111
Fax
(714) 963-4642
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7875T CA Primary
Corneal and Contact Management Optometrist 152WC0802X OP7875T CA

Addresses

Primary practice location

18449 Brookhurst St
Ste 6
Fountain Valley, CA 92708-6751

Mailing address

18449 Brookhurst St
Ste 6
Fountain Valley, CA 92708-6751
Phone (714) 963-2111

Other identifiers 1

IdentifierTypeStateIssuer
SDOO78750OtherBLUE SHIELD OF CA

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
I20051220000637 CA Practitioner - Optometry 5597787556 Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
7875TCAMDOptometrist
OP7875TCAMDCorneal and Contact Management Optometrist
7875CAMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sako and Kame Optometric Corp Optometrist CurrentSince Sep 5, 2021 Accepting new patients

Locations

18449 Brookhurst St
Ste 6
Fountain Vly, CA 92708
Phone (714) 519-8885

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1689639429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18449 BROOKHURST ST",
            "address_2": "STE 6",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086751",
            "telephone_number": "714-963-2111",
            "fax_number": "714-963-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18449 BROOKHURST ST",
            "address_2": "STE 6",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086751",
            "telephone_number": "714-963-2111",
            "fax_number": "714-963-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERMAN",
        "first_name": "JAMES",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7875T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OP7875T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "SDOO78750",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.