Individual provider Active NPI

Larry James Simpfenderfer, O.D.

  • Optometrist
  • Lodi, CA
National Provider Identifier
1902947179
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT7804TPL Issued in CA
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

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
SD0078040MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.63 of 100Reported as group
Quality
94
Improvement activities
40
Cost
43.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7804CAMDAddiction (Substance Use Disorder) Counselor
OPT7804TPLCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Manshadi Heart Institute Inc PastSince Dec 11, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.