Individual provider Active NPI

Harvey H. Yamamoto, OD

  • Optometrist
  • Ontario, CA
National Provider Identifier
1881661700
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4477T Issued in CA
Practice address
417 N Euclid Ave
Ontario, CA 91762-3427
Phone
(909) 986-9951
Fax
(909) 986-9812
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4477T CA Primary

Addresses

Primary practice location

417 N Euclid Ave
Ontario, CA 91762-3427

Mailing address

417 N Euclid Ave
Ontario, CA 91762-3427
Phone (909) 986-9951

Other identifiers 1

IdentifierTypeStateIssuer
SD0044770MedicaidCA

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
I20111214000427 CA Practitioner - Optometry 8921118803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4477TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey H Yamamoto, OD, Inc. Optometrist CurrentSince Jan 1, 1966 Accepting new patients

Locations

417 N Euclid Ave
Ontario, CA 91762
Phone (909) 986-9951

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1881661700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623427",
            "telephone_number": "909-986-9951",
            "fax_number": "909-986-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623427",
            "telephone_number": "909-986-9951",
            "fax_number": "909-986-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "HARVEY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4477T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0044770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.