Active NPI
Larry James Simpfenderfer, O.D.
- Optometrist
- Lodi, CA
National Provider Identifier
1902947179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT7804TPL
- Practice address
- 1210 W Tokay St
Lodi, CA 95240-3810 - Phone
- (209) 334-2626
- Fax
- (209) 334-0710
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT7804TPL | CA | Primary |
Addresses
Primary practice location
1210 W Tokay St
Lodi, CA 95240-3810
Mailing address
1210 W Tokay St
Lodi, CA 95240-3810
Phone (209) 334-2626
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0078040 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.63 of 100
- Quality
- 94
- Improvement activities
- 40
- Cost
- 43.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7804 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| OPT7804TPL | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manshadi Heart Institute Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JDABCA
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.
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- Stockton, CA
- NPI 1225380603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1902947179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 W TOKAY ST",
"city": "LODI",
"state": "CA",
"postal_code": "952403810",
"telephone_number": "209-334-2626",
"fax_number": "209-334-0710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 W TOKAY ST",
"city": "LODI",
"state": "CA",
"postal_code": "952403810",
"telephone_number": "209-334-2626",
"fax_number": "209-334-0710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMPFENDERFER",
"first_name": "LARRY",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT7804TPL",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0078040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.