Individual provider Active NPI

Michele A Rogers, OD

  • Optometrist
  • Redondo Beach, CA
National Provider Identifier
1821070624
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12119T Issued in CA
Practice address
520 N Prospect Ave
Ste 206
Redondo Beach, CA 90277-3042
Phone
(424) 290-1520
Fax
(310) 798-9228
NPI assigned
Nov 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12119T CA Primary

Addresses

Primary practice location

520 N Prospect Ave
Ste 206
Redondo Beach, CA 90277-3042

Mailing address

520 N Prospect Ave
Ste 206
Redondo Beach, CA 90277-3042
Phone (424) 290-1520

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
I20170418001556 CA Practitioner - Optometry 4587827175 Practice locations: El Segundo, CA; Redondo Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

390 N Sepulveda Blvd
Suite 1100
El Segundo, CA 90245-4476
Phone (424) 290-1520

520 N Prospect Ave
Suite 206
Redondo Beach, CA 90277-3042
Phone (424) 290-1520

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12119TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aslam Optometry Group P.C. Optometrist CurrentSince Sep 1, 2019 Accepting new patients
Eileen J. Bell Optometrist CurrentSince Oct 15, 2015 Accepting new patients
Semel Vision Care Past Accepting new patients

Locations

302 W Grand Ave
Ste 1
El Segundo, CA 90245
Phone (310) 414-9595

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1821070624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "STE 206",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773042",
            "telephone_number": "424-290-1520",
            "fax_number": "310-798-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "STE 206",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773042",
            "telephone_number": "424-290-1520",
            "fax_number": "310-798-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MICHELE",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12119T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.