Individual provider Active NPI

Elizabeth Bennett Anderson, O.D.

  • Optometrist
  • Hollister, CA
National Provider Identifier
1972814341
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10025T Issued in CA
Practice address
365 6TH St
Hollister, CA 95023-3834
Phone
(831) 637-5536
Fax
(831) 637-7601
NPI assigned
Jun 30, 2010
Last updated
Nov 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 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 10025T CA Primary

Addresses

Primary practice location

365 6TH St
Hollister, CA 95023-3834

Mailing address

365 6TH St
Hollister, CA 95023-3834
Phone (831) 637-5536

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
I20110212000039 CA Practitioner - Optometry 1658496583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert M Theaker O D an Optometric CorporationGroup PAC ID 1254523418, 2 clinicians

Practice addresses (Care Compare)

365 6TH St
Hollister, CA 95023-3834
Phone (831) 637-5536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Robert M Theaker O D an Optometric Corporation Optometrist CurrentSince Oct 31, 2010 Accepting new patients
Hattori Vision Optometry PastSince Mar 1, 2012 Accepting new patients

Locations

365 6th St
Hollister, CA 95023
Phone (831) 637-5536

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1972814341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 6TH ST",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233834",
            "telephone_number": "831-637-5536",
            "fax_number": "831-637-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 6TH ST",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233834",
            "telephone_number": "831-637-5536",
            "fax_number": "831-637-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELIZABETH",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10025T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

Verify at the official NPI Registry.