Active NPI
Brad Anthony Baggarly, O.D.
- Optometrist
- Claremont, CA
National Provider Identifier
1861541617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9471-T
- Practice address
- 695 W Foothill Blvd
Claremont, CA 91711-3490 - Phone
- (909) 625-7861
- Fax
- (909) 621-0742
- NPI assigned
- Jan 10, 2007
- Last updated
- Apr 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9471-T | CA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 9471-T | CA | |
| Pediatric Optometrist | 152WP0200X | 9471-T | CA |
Addresses
Primary practice location
695 W Foothill Blvd
Claremont, CA 91711-3490
Mailing address
695 W Foothill Blvd
Claremont, CA 91711-3490
Phone (909) 625-7861
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WOP9471A | Other | CA | MEDICARE PTAN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
695 W Foothill Blvd
Claremont, CA 91711-3490
Phone (909) 625-7861
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9471-T | CA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brad a Baggarly O D Inc | Optometrist | Current | Accepting new patients |
Locations
695 W Foothill Blvd
Claremont, CA 91711
Phone (909) 625-7861
Organizations & group practices 2
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.
-
- Optometrist
- Claremont, CA
- NPI 1710105846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333411200000",
"number": "1861541617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 W FOOTHILL BLVD",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917113490",
"telephone_number": "909-625-7861",
"fax_number": "909-621-0742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 W FOOTHILL BLVD",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917113490",
"telephone_number": "909-625-7861",
"fax_number": "909-621-0742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGGARLY",
"first_name": "BRAD",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2012-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9471-T",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "9471-T",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "CA",
"license": "9471-T",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "WOP9471A",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Claremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.