Individual provider Active NPI

Yvonne Macintosh, OPTICIAN

  • Optician
  • Modesto, CA
National Provider Identifier
1942519145
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
SL1455 Issued in CA
Practice address
2909 E Hatch Rd
Modesto, CA 95351-4921
Phone
(209) 552-6754
Fax
(209) 537-4802
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X SL1455 CA Primary

Addresses

Primary practice location

2909 E Hatch Rd
Modesto, CA 95351-4921

Mailing address

2909 E Hatch Rd
Modesto, CA 95351-4921
Phone (209) 552-6754

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SL1455CAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Yvonne Macintosh Transport CurrentSince Feb 6, 2022 Accepting new patients
Macintosh II Transport LLC CurrentSince Nov 6, 2022 Accepting new patients

Locations

2909 E Hatch Rd
Modesto, CA 95351
Phone (209) 552-6754

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1942519145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 E HATCH RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514921",
            "telephone_number": "209-552-6754",
            "fax_number": "209-537-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 E HATCH RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514921",
            "telephone_number": "209-552-6754",
            "fax_number": "209-537-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINTOSH",
        "first_name": "YVONNE",
        "name_prefix": "Mrs.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "SL1455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.