Active NPI
Tara Pahlevan-Chaleshtari
- Optometrist
- Berkeley, CA
National Provider Identifier
1932654043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 33504
- Practice address
- 200 Minor Hall
Berkeley, CA 94720 - Phone
- (510) 642-0945
- NPI assigned
- Aug 18, 2016
- Sex
- Female
- 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 | 33504 | CA | Primary |
Addresses
Primary practice location
200 Minor Hall
Berkeley, CA 94720
Mailing address
200 Minor Hall
Berkeley, CA 94720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33504 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Bay Eye Centers Medical Corporation | Past | Accepting new patients |
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.
-
- Specialist
- San Ramon, CA
- NPI 1780633644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471478400000",
"number": "1932654043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MINOR HALL",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MINOR HALL",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94720",
"telephone_number": "510-642-0945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAHLEVAN-CHALESHTARI",
"first_name": "TARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-18",
"last_updated": "2016-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "33504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.