Individual provider Active NPI

Maria Guadalupe Cardenas, OD

  • Optometrist
  • Watsonville, CA
National Provider Identifier
1790266377
Registry record updated Jun 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34020TLG Issued in CA
Practice address
204 E Beach St
Watsonville, CA 95076
Phone
(831) 728-0222
NPI assigned
Aug 22, 2018
Last updated
Jun 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34020TLG CA Primary

Addresses

Primary practice location

204 E Beach St
Watsonville, CA 95076

Mailing address

3400 Stevenson Blvd Apt P31
Fremont, CA 94538-5848
Phone (831) 998-1187

Other practice location 1

45 Neilson St
Watsonville, CA 95076-2468
Phone (831) 728-0222

Other practice location 2

1332 E 14th St
San Leandro, CA 94577-4714
Phone (510) 614-2020

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
I20181012000862 CA Practitioner - Optometry 4688926058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Para la GenteGroup PAC ID 8729984729, 41 clinicians

Practice addresses (Care Compare)

195 Aviation Way
Suite 200
Watsonville, CA 95076-2059

204 E Beach St
Watsonville, CA 95076-4809
Phone (831) 728-8250

45 Neilson St
Watsonville, CA 95076-2468
Phone (831) 728-8250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34020CAMDPsychologist
34020TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince Jan 19, 2019 Accepting new patients
Salud Para la Gente CurrentSince Jan 19, 2019 Accepting new patients
Flores Optometry Inc Optometrist PastSince Sep 9, 2010 Accepting new patients

Locations

195 Aviation Way
Ste 200
Watsonville, CA 95076

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

45 Nielson St
Watsonville, CA 95076
Phone (831) 761-1588

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560556800000",
    "number": "1790266377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 STEVENSON BLVD APT P31",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385848",
            "telephone_number": "831-998-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E BEACH ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "95076",
            "telephone_number": "831-728-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Neilson St",
            "address_purpose": "LOCATION",
            "city": "Watsonville",
            "state": "CA",
            "postal_code": "950762468",
            "country_code": "US",
            "telephone_number": "831-728-0222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1332 E 14th St",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774714",
            "country_code": "US",
            "telephone_number": "510-614-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "MARIA",
        "middle_name": "GUADALUPE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2019-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34020TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.