Organization Active NPI

Associated Eye Specialists Medical Group Inc

  • Ophthalmology Physician
  • Santa Barbara, CA
National Provider Identifier
1932396421
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G059821 Issued in CA
Legal business name
ASSOCIATED EYE SPECIALISTS MEDICAL GROUP INC
Practice address
515 E Micheltorena St Ste D
Santa Barbara, CA 93103-4224
Phone
(805) 963-4272
Fax
(805) 563-0883
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Dr. Robert William Poulin, M.D.NPI 1457461204
Title
President
Phone
(805) 729-3575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G059821 CA Primary

Addresses

Primary practice location

515 E Micheltorena St Ste D
Santa Barbara, CA 93103-4224

Mailing address

2939 Lomita Rd
Santa Barbara, CA 93105-3317
Phone (805) 729-3575

Other identifiers 1

IdentifierTypeStateIssuer
1457461204OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120424000297 CA Part B Supplier - Clinic/Group Practice 3779745591 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Barbara, CA

National Provider Directory

National Provider Directory

Locations

5333 Hollister Ave
Ste 105
Santa Barbara, CA 93111
Phone (805) 439-6871

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1932396421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 LOMITA RD",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053317",
            "telephone_number": "805-729-3575",
            "fax_number": "805-563-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E MICHELTORENA ST STE D",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931034224",
            "telephone_number": "805-963-4272",
            "fax_number": "805-563-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED EYE SPECIALISTS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "POULIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-729-3575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G059821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457461204",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.