Colin Simmons Funnell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

34354TLG Issued in CA

Practice address

1445 Donlon St Ste 12
Ventura, CA 93003-8390

Phone

(805) 642-3777

Fax

(805) 644-6491

NPI assigned

Aug 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Funnell Optometry Inc

  • Optometrist
  • Ventura, CA
  • NPI 1649966334
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1972151652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 DONLON ST STE 12",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930038390",
            "telephone_number": "805-624-3777",
            "fax_number": "805-644-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 DONLON ST STE 12",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930038390",
            "telephone_number": "805-642-3777",
            "fax_number": "805-644-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNNELL",
        "first_name": "COLIN",
        "middle_name": "SIMMONS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "34354TLG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "34354TLG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "34354TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34354TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rob L Frye
• Anthony Jalen Fryer, MHA
• Dianne M Fukes, PT
• Keiko Fukue, MSW, ASW
• Deana Fuller
• Thomas Roy Funnell, OD
• Jill E. Furgurson, M.D.
• Maki Furuya, LCSW
• Victoria Lynn Fye, LCSW
• Roxanne Gaggs, M.S.

• Optometrist in Ventura, CA
• Providers in Ventura, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.