Individual provider Active NPI

David Farberow, O.D.

  • Optometrist
  • Santa Cruz, CA
National Provider Identifier
1770653180
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6912T Issued in CA
Practice address
1537 Pacific Ave
Suite 100
Santa Cruz, CA 95060-3942
Phone
(831) 429-2020
Fax
(831) 429-2945
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6912T CA Primary

Addresses

Primary practice location

1537 Pacific Ave
Suite 100
Santa Cruz, CA 95060-3942

Mailing address

1537 Pacific Ave
Suite 100
Santa Cruz, CA 95060-3942
Phone (831) 429-2020

Other identifiers 1

IdentifierTypeStateIssuer
77-0413139OtherCAFED TAX ID

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
I20081023000624 CA Practitioner - Optometry 2466510193 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6912TCAMDOptometrist
66912CAMDPharmacist

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1770653180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 PACIFIC AVE",
            "address_2": "SUITE 100",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603942",
            "telephone_number": "831-429-2020",
            "fax_number": "831-429-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 PACIFIC AVE",
            "address_2": "SUITE 100",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603942",
            "telephone_number": "831-429-2020",
            "fax_number": "831-429-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARBEROW",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6912T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "77-0413139",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.