Active NPI
Gary Hamill
- Optometrist
- San Mateo, CA
National Provider Identifier
1699833152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5866T
- Practice address
- 152 N San Mateo Dr
San Mateo, CA 94401-2761 - Phone
- (650) 344-2555
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5866T | CA | Primary |
Addresses
Primary practice location
152 N San Mateo Dr
San Mateo, CA 94401-2761
Mailing address
117 N San Mateo Dr
San Mateo, CA 94401-2708
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ78500Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5866T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300752000000",
"number": "1699833152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 N SAN MATEO DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 N SAN MATEO DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012761",
"telephone_number": "650-344-2555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILL",
"first_name": "GARY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2011-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5866T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ78500Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.