Individual provider Active NPI

Weyland Dear, OD

  • Optometrist
  • San Jose, CA
National Provider Identifier
1902981517
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10684T Issued in CA
Practice address
1375 Blossom Hill Rd
Ste 7
San Jose, CA 95118-3806
Phone
(408) 295-0246
Fax
(408) 292-0507
NPI assigned
Oct 25, 2006
Last updated
Mar 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10684T CA Primary

Addresses

Primary practice location

1375 Blossom Hill Rd
Ste 7
San Jose, CA 95118-3806

Mailing address

1375 Blossom Hill Rd
Ste 7
San Jose, CA 95118-3806
Phone (408) 295-0246

Other identifiers 1

IdentifierTypeStateIssuer
SD0106840MedicaidCA

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
I20081211000307 CA Practitioner - Optometry 0345130514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1375 Blossom Hill Rd
Suite 7
San Jose, CA 95118-3806
Phone (408) 264-1264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
In Focus Optometry, Inc Optometrist CurrentSince Jul 1, 1999 Accepting new patients
In Focus Optometry, Inc Optometrist CurrentSince Oct 12, 1999 Accepting new patients

Locations

1375 Blossom Hill Rd
Ste 7
San Jose, CA 95118
Phone (408) 264-1264

42 S 1st St
San Jose, CA 95113
Phone (408) 295-0246

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1902981517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 BLOSSOM HILL RD",
            "address_2": "STE 7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951183806",
            "telephone_number": "408-295-0246",
            "fax_number": "408-292-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 BLOSSOM HILL RD",
            "address_2": "STE 7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951183806",
            "telephone_number": "408-295-0246",
            "fax_number": "408-292-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAR",
        "first_name": "WEYLAND",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10684T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.