Individual provider Active NPI

Leila Ahmadi, O.D.

  • Optometrist
  • Mission Viejo, CA
National Provider Identifier
1962595009
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10838TPG Issued in CA
Practice address
26800 Crown Valley Parkway
Suite #308
Mission Viejo, CA 92691-8050
Phone
(949) 489-2300
Fax
(949) 489-2301
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10838TPG CA Primary

Addresses

Primary practice location

26800 Crown Valley Parkway
Suite #308
Mission Viejo, CA 92691-8050

Mailing address

26800 Crown Valley Parkway
Suite #308
Mission Viejo, CA 92691-8050
Phone (949) 489-2300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000869 CA Practitioner - Optometry 7113085879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-County Eye Institute IncGroup PAC ID 6305994294, 6 clinicians

Practice addresses (Care Compare)

1124 S Main St
Suite 101
Corona, CA 92882-4449
Phone (951) 737-6363

26800 Crown Valley Pkwy
Suite 308
Mission Viejo, CA 92691-8050
Phone (949) 489-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10838TPGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Leila Ahmadi OD, Apc, an Optometric Corporation Optometrist CurrentSince Nov 27, 2012 Accepting new patients
Luxottica of America Inc Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

26800 Crown Valley Pkwy
Ste 308
Mission Viejo, CA 92691
Phone (949) 218-4488

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1962595009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PARKWAY",
            "address_2": "SUITE #308",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918050",
            "telephone_number": "949-489-2300",
            "fax_number": "949-489-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PARKWAY",
            "address_2": "SUITE #308",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918050",
            "telephone_number": "949-489-2300",
            "fax_number": "949-489-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADI",
        "first_name": "LEILA",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10838TPG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.