Individual provider Active NPI

Gary S Lax, O.D.

  • Optometrist
  • Ventura, CA
National Provider Identifier
1700928363
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6072 Issued in CA
Practice address
4744 Telephone Rd
3
Ventura, CA 93003-5244
Phone
(805) 642-4185
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6072 CA Primary

Addresses

Primary practice location

4744 Telephone Rd
3
Ventura, CA 93003-5244

Mailing address

4601 Telephone Rd
Ste 109
Ventura, CA 93003-5671
Phone (805) 642-4185

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
I20100823000836 CA Practitioner - Optometry 0345374625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strickland Optometric Corporation Optometrist CurrentSince Mar 1, 2016 Accepting new patients

Locations

4601 Telephone Rd
Ste 109
Ventura, CA 93003
Phone (805) 642-4185

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1700928363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 TELEPHONE RD",
            "address_2": "STE 109",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035671",
            "telephone_number": "805-642-4185",
            "fax_number": "805-642-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 TELEPHONE RD",
            "address_2": "3",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035244",
            "telephone_number": "805-642-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAX",
        "first_name": "GARY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.