Individual provider Active NPI

Matthew Thornton, OD

  • Optometrist
  • Valencia, CA
National Provider Identifier
1760150601
Registry record updated Sep 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34950 Issued in CA
Practice address
25862 McBean Pkwy
Valencia, CA 91355-2004
Phone
(661) 259-1662
NPI assigned
Sep 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 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 34950 CA Primary

Addresses

Primary practice location

25862 McBean Pkwy
Valencia, CA 91355-2004

Mailing address

11346 Iowa Ave Apt 108
Los Angeles, CA 90025-6083
Phone (954) 663-8129

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
I20211227000644 CA Practitioner - Optometry 2466843602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern College of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Sun and Dr Sjolund Optometric CorpGroup PAC ID 8820490147, 3 clinicians
Elander Eye Medical Group IncGroup PAC ID 3274577879, 5 clinicians

Practice addresses (Care Compare)

1355 4TH St
Santa Monica, CA 90401-1301
Phone (310) 394-1011

242 26TH St
Santa Monica, CA 90402-2524
Phone (310) 393-0634

906 San Fernando Rd
San Fernando, CA 91340-3311
Phone (818) 361-1513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34950CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elander Eye Medical Group Inc CurrentSince Jun 27, 2022 Accepting new patients
Dr. Daniel Sjolund and Dr. Alice Sun, Optometric Corporation Optometrist CurrentSince Sep 21, 2021 Accepting new patients
Dr Sun and Dr Sjolund Optometric Corp Optometrist CurrentSince Jul 9, 2023 Accepting new patients
Dr. Daniel Sjolund and Dr. Alice Sun, Optometric Corporation Optometrist Past Accepting new patients

Locations

906 San Fernando Rd
San Fernando, CA 91340
Phone (818) 361-1513

242 26th St
Santa Monica, CA 90402
Phone (310) 393-0634

1355 4th St
Santa Monica, CA 90401
Phone (310) 394-1011

27335 Tourney Rd
Ste 180
Valencia, CA 91355
Phone (661) 259-1662

25862 McBean Pkwy
Valencia, CA 91355
Phone (616) 259-1662

Organizations & group practices 4

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": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630713600000",
    "number": "1760150601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11346 IOWA AVE APT 108",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256083",
            "telephone_number": "954-663-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25862 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552004",
            "telephone_number": "661-259-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-04",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.