Individual provider Active NPI

David A. Modlinger, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1740630763
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33370-TLG Issued in CA
Practice address
510 S Alvarado St
Los Angeles, CA 90057-2904
Phone
(213) 483-3600
NPI assigned
Jun 21, 2016
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 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 OPT33370-TLG CA Primary

Addresses

Primary practice location

510 S Alvarado St
Los Angeles, CA 90057-2904

Mailing address

1465 South Durango Ave
Los Angeles, CA 90035
Phone (818) 388-2248

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
I20170112000474 CA Practitioner - Optometry 6507147295 Reassigns benefits to 2 organizations
Practice locations: Reseda, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT33370-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritana Medical Clinic,Inc. CurrentSince Dec 20, 2016 Accepting new patients
Los Angeles Clinica Medica General Medical Center, Inc. CurrentSince Sep 1, 2022 Accepting new patients
South Central Family Health Center Past Accepting new patients

Locations

122 E Washington Blvd
Los Angeles, CA 90015
Phone (213) 741-0400

2208 W 7th St
Los Angeles, CA 90057
Phone (213) 384-3434

510 S Alvarado St
Los Angeles, CA 90057
Phone (213) 483-3600

Interoperability endpoints

  • Direct secure messaging: david.modlinger.p1@direct.scfhc.nextgenshare.com
  • Direct secure messaging: dmodlinger185322@direct.ochin.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1740630763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 SOUTH DURANGO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90035",
            "telephone_number": "818-388-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572904",
            "telephone_number": "213-483-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODLINGER",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33370-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.