Individual provider Active NPI

Surbjeet Kaur Mann, O.D.

  • Optometrist
  • Fresno, CA
National Provider Identifier
1689708448
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13090T Issued in CA
Practice address
5478 N Palm Ave
Fresno, CA 93704-1940
Phone
(559) 447-4990
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13090T CA Primary

Addresses

Primary practice location

5478 N Palm Ave
Fresno, CA 93704-1940

Mailing address

6920 W Robinwood LN
Fresno, CA 93723-4005
Phone (559) 274-8007

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
I20150706000294 CA Order and Referring Only - OptometryPractitioner - Optometry 5193868107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13090CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Saul Mendelsohn Optometrist a Professional Corp Optometrist PastSince Jan 1, 2003 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: surbjeet.mann.1@17661.direct.athenahealth.com

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1689708448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 W ROBINWOOD LN",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937234005",
            "telephone_number": "559-274-8007",
            "fax_number": "559-447-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5478 N PALM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937041940",
            "telephone_number": "559-447-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "SURBJEET",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13090T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.