Individual provider Active NPI

Eric Bass, O.D.

  • Optometrist
  • Westminster, CA
National Provider Identifier
1780765289
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8249T Issued in CA
Practice address
15068 Goldenwest St
Westminster, CA 92683-6152
Phone
(714) 898-5631
Fax
(714) 898-6576
NPI assigned
Oct 18, 2006
Last updated
Apr 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8249T CA Primary

Addresses

Primary practice location

15068 Goldenwest St
Westminster, CA 92683-6152

Mailing address

15068 Goldenwest St
Westminster, CA 92683-6152
Phone (714) 898-5631

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
I20070427000246 CA Practitioner - Optometry 9830159003 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Orange, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8249TCAMDOptometrist
8249CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fourth Optometric Care of California Optometrist CurrentSince Apr 25, 2023 Accepting new patients
Fourth Optometric Care of California Optometrist Current Accepting new patients
Fourth Optometric Care of California Optometrist CurrentSince Apr 25, 2023 Accepting new patients

Locations

946 Manhattan Beach Blvd
Manhattan Beach, CA 90266
Phone (310) 545-4585

130 S Main St
Orange, CA 92868
Phone (714) 939-9202

130 S Main St
Ste F
Orange, CA 92868
Phone (714) 939-9202

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

4505 Sepulveda Blvd
Torrance, CA 90505
Phone (310) 792-2020

15068 Goldenwest St
Westminster, CA 92683
Phone (714) 898-5631

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1780765289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15068 GOLDENWEST ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836152",
            "telephone_number": "714-898-5631",
            "fax_number": "877-539-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15068 GOLDENWEST ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836152",
            "telephone_number": "714-898-5631",
            "fax_number": "714-898-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8249T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.