Individual provider Active NPI

Stephanie Anne Burris, O.D.

  • Optometrist
  • Santa Barbara, CA
National Provider Identifier
1871666057
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10928T Issued in CA
Practice address
1629 State St
Santa Barbara, CA 93101-2548
Phone
(805) 569-2318
Fax
(805) 569-0230
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10928T CA Primary

Addresses

Primary practice location

1629 State St
Santa Barbara, CA 93101-2548

Mailing address

1629 State St
Santa Barbara, CA 93101-2548
Phone (805) 569-2318

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
I20120329000244 CA Practitioner - Optometry 5395905301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wendy L. Santizo, a Prof. Corp.Group PAC ID 0749236099, 3 clinicians

Practice addresses (Care Compare)

1629 State St
Suite 1
Santa Barbara, CA 93101-2548
Phone (805) 569-2318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10928TCAMDOptometrist

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1871666057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012548",
            "telephone_number": "805-569-2318",
            "fax_number": "805-569-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 STATE ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012548",
            "telephone_number": "805-569-2318",
            "fax_number": "805-569-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10928T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.