Active NPI
Dena Thamsopit, O.D.
- Optometrist
- Phelan, CA
National Provider Identifier
1740410307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 13806
- Practice address
- 4355 Phelan Rd
Phelan, CA 92371-7675 - Phone
- (760) 868-2020
- Fax
- (760) 868-7675
- NPI assigned
- Jul 16, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 13806 | CA | Primary |
Addresses
Primary practice location
4355 Phelan Rd
Phelan, CA 92371-7675
Mailing address
20670 Fuero Dr
Walnut, CA 91789-2408
Phone (909) 348-3572
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091204000238 | CA | Practitioner - Optometry | 0143369132 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
9550 Escondido Ave
Hesperia, CA 92345-9120
Phone (833) 574-2273
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
9550 Escondido Ave
Hesperia, CA 92345
Phone (760) 662-2500
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
Organizations & group practices 7
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.
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
CA
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Clinical Medical Laboratory
- N Hollywood, CA
- NPI 1891873303
-
- Health Maintenance Organization
- Woodland Hills, CA
- NPI 1952333478
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Fontana, CA
- NPI 1316463763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1740410307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20670 FUERO DR",
"city": "WALNUT",
"state": "CA",
"postal_code": "917892408",
"telephone_number": "909-348-3572",
"fax_number": "909-594-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4355 PHELAN RD",
"city": "PHELAN",
"state": "CA",
"postal_code": "923717675",
"telephone_number": "760-868-2020",
"fax_number": "760-868-7675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAMSOPIT",
"first_name": "DENA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-16",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13806",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4355 Phelan Rd",
"city": "Phelan",
"state": "CA",
"country_code": "US",
"postal_code": "923717675",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Phelan, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.