Individual provider Active NPI

James W Weitkamp, O.D.

  • Optometrist
  • Arroyo Grande, CA
National Provider Identifier
1811040413
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13063 Issued in CA
Practice address
260 S Halcyon Rd
Arroyo Grande, CA 93420-3135
Phone
(805) 489-8410
Fax
(805) 233-6375
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13063 CA Primary
Optician 156FX1800X

Addresses

Primary practice location

260 S Halcyon Rd
Arroyo Grande, CA 93420-3135

Mailing address

260 S Halcyon Rd
Arroyo Grande, CA 93420-3135
Phone (805) 489-8410

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
I20070423000452 CA Practitioner - Optometry 7810092640 Reassigns benefits to 1 organization
Practice locations: Arroyo Grande, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1118 E Grand Ave
Arroyo Grande, CA 93420-2590
Phone (805) 489-5577

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arroyo Grande Optometry, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Richard Martin, M.D. Rehabilitative and Restorative Medicine Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

1118 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 489-5577

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1811040413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S HALCYON RD",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203135",
            "telephone_number": "805-489-8410",
            "fax_number": "805-233-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 S HALCYON RD",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203135",
            "telephone_number": "805-489-8410",
            "fax_number": "805-233-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITKAMP",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13063",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.