Individual provider Active NPI

Xavier P Ordonez, O.D.

  • Optometrist
  • Whittier, CA
National Provider Identifier
1750488193
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11089T Issued in CA
Practice address
13124 Philadelphia St
Whittier, CA 90601-4301
Phone
(562) 945-3589
Fax
(562) 945-5788
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11089T CA Primary

Addresses

Primary practice location

13124 Philadelphia St
Whittier, CA 90601-4301

Mailing address

13124 Philadelphia St
Whittier, CA 90601-4301
Phone (562) 945-3589

Other identifiers 2

IdentifierTypeStateIssuer
SD0110890MedicaidCA
1750488193MedicaidCA

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
I20040527000530 CA Practitioner - Optometry 4385625193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13124 Philadelphia St
Whittier, CA 90601-4301
Phone (562) 945-3589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11089TCAMDOptometrist
11089CAMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Xavier P Ordonez OD a Professional Corporation Optometrist CurrentSince Sep 18, 2006 Accepting new patients
Frederick M. Raymond MD Past Accepting new patients

Locations

6325 Hollywood Blvd
Los Angeles, CA 90028
Phone (323) 409-3131

7247 Painter Ave
Whittier, CA 90602
Phone (562) 945-3589

13124 Philadelphia St
Whittier, CA 90601
Phone (562) 945-3589

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1750488193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13124 PHILADELPHIA ST",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014301",
            "telephone_number": "562-945-3589",
            "fax_number": "562-945-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13124 PHILADELPHIA ST",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014301",
            "telephone_number": "562-945-3589",
            "fax_number": "562-945-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDONEZ",
        "first_name": "XAVIER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11089T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0110890",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750488193",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.