Individual provider Active NPI

David Michael Redman, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1841280989
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9692T Issued in CA
Practice address
117 Bernal Rd
Suite 40
San Jose, CA 95119-1375
Phone
(408) 362-9789
Fax
(408) 362-9790
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9692T CA Primary

Addresses

Primary practice location

117 Bernal Rd
Suite 40
San Jose, CA 95119-1375

Mailing address

1039 El Monte Ave
Suite K
Mountain View, CA 94040-2370
Phone (650) 967-0140

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
I20100811000126 CA Practitioner - Optometry 2163555434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9692TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fyidoctors of California, Inc. Optometrist CurrentSince Aug 16, 2021 Accepting new patients

Locations

1039 El Monte Ave
Ste K
Mountain View, CA 94040
Phone (650) 967-0140

114 N Sunrise Ave
Ste C4
Roseville, CA 95661
Phone (916) 786-2212

117 Bernal Rd
Ste 40
San Jose, CA 95119
Phone (408) 362-9789

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1841280989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 EL MONTE AVE",
            "address_2": "SUITE K",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402370",
            "telephone_number": "650-967-0140",
            "fax_number": "650-967-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BERNAL RD",
            "address_2": "SUITE 40",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191375",
            "telephone_number": "408-362-9789",
            "fax_number": "408-362-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMAN",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9692T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.