Active NPI
Sandra Owyoung, O.D.
- Optometrist
- Madera, CA
National Provider Identifier
1962538199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4667T
- Practice address
- 1930 Howard Rd
Suite 122
Madera, CA 93637-5154 - Phone
- (559) 661-1927
- Fax
- (559) 661-1917
- NPI assigned
- Feb 23, 2007
- 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 | 4667T | CA | Primary |
Addresses
Primary practice location
1930 Howard Rd
Suite 122
Madera, CA 93637-5154
Mailing address
1930 Howard Rd
Suite 122
Madera, CA 93637-5154
Phone (559) 661-1927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0046670 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110302000736 | CA | Practitioner - Optometry | 0941481535 | Practice locations: Madera, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4667T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962538199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 HOWARD RD",
"address_2": "SUITE 122",
"city": "MADERA",
"state": "CA",
"postal_code": "936375154",
"telephone_number": "559-661-1927",
"fax_number": "559-661-1917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 HOWARD RD",
"address_2": "SUITE 122",
"city": "MADERA",
"state": "CA",
"postal_code": "936375154",
"telephone_number": "559-661-1927",
"fax_number": "559-661-1917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWYOUNG",
"first_name": "SANDRA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4667T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0046670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.