Individual provider Active NPI

Fatin Saleh, O.D.

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1922556786
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34694 Issued in CA
Practice address
12263 Highland Ave Ste 120
Rancho Cucamonga, CA 91739-2576
Phone
(909) 899-5001
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3012 CT
Optometrist 152W00000X 34694 CA Primary

Addresses

Primary practice location

12263 Highland Ave Ste 120
Rancho Cucamonga, CA 91739-2576

Mailing address

12263 Highland Ave Ste 120
Rancho Cucamonga, CA 91739-2576
Phone (909) 899-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170816003096 CT Practitioner - Optometry 6608148291 Reassigns benefits to 1 organization
I20210419002260 CA Practitioner - Optometry 6608148291 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Clear View Optometry, PC Optometrist CurrentSince Apr 14, 2021 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Jun 27, 2017 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Jun 27, 2017 Accepting new patients

Locations

12263 Highland Ave
Ste 120
Rancho Cucamonga, CA 91739
Phone (909) 899-5001

145 Wakelee Ave
Ansonia, CT 06401
Phone (203) 734-1686

87 Grandview Ave
Waterbury, CT 06708
Phone (203) 465-1353

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1922556786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12263 HIGHLAND AVE STE 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392576",
            "telephone_number": "909-899-5001",
            "fax_number": "909-899-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12263 HIGHLAND AVE STE 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392576",
            "telephone_number": "909-899-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEH",
        "first_name": "FATIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3012",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.