Individual provider Active NPI

Vanessa Ferrucci, O.D.

  • Optometrist
  • Burbank, CA
National Provider Identifier
1851368419
Registry record updated Jan 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12117T Issued in CA
Practice address
4100 W Alameda Ave
Burbank, CA 91505-4195
Phone
(818) 841-1212
Fax
(818) 841-6768
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12117T CA Primary

Addresses

Primary practice location

4100 W Alameda Ave
Burbank, CA 91505-4195

Mailing address

14610 Morrison St
Sherman Oaks, CA 91403-1649
Phone (818) 789-2809

Other identifiers 1

IdentifierTypeStateIssuer
SDO12117OMedicaidCA

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
I20031218001050 CA Practitioner - Optometry 2860399532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4100 W Alameda Ave
Suite 102
Burbank, CA 91505-4153
Phone (818) 841-1212

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12117TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ferrucci Optometric Corporation Optometrist CurrentSince Dec 20, 2015 Accepting new patients
Craig W Hoeft Past Accepting new patients
Granada Hills Optometry Center Optometrist Past Accepting new patients
Eric W Leser OD a Professional Corporation Optometrist PastSince Mar 30, 2011 Accepting new patients
Robert E. Brill Past Accepting new patients

Locations

4100 W Alameda Ave
Ste 102
Burbank, CA 91505
Phone (818) 841-1212

4100 W Alameda Ave
Burbank, CA 91505
Phone (818) 651-9098

Organizations & group practices 5

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452297600000",
    "number": "1851368419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14610 MORRISON ST",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031649",
            "telephone_number": "818-789-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054195",
            "telephone_number": "818-841-1212",
            "fax_number": "818-841-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRUCCI",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2016-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12117T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SDO12117O",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.