Individual provider Active NPI

Sheiva Lenore Pousti, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1730240052
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
104030T Issued in CA
Practice address
3560 Fairmount Ave
San Diego, CA 92105-3420
Phone
(619) 431-2020
Fax
(619) 376-2100
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 104030T CA Primary

Addresses

Primary practice location

3560 Fairmount Ave
San Diego, CA 92105-3420

Mailing address

7514 Girard Ave Ste 1231
La Jolla, CA 92037-5149
Phone (858) 504-2020

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
I20040121000912 CA Practitioner - Optometry 6204738230 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104030TCAMDOptometrist
10403CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Vision Care, Inc. Optometrist PastSince Apr 23, 2023 Accepting new patients

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1730240052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 GIRARD AVE STE 1231",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375149",
            "telephone_number": "858-504-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053420",
            "telephone_number": "619-431-2020",
            "fax_number": "619-376-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUSTI",
        "first_name": "SHEIVA",
        "middle_name": "LENORE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "104030T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.