Active NPI
Michael Matherne, O.D.
- Optometrist
- North Hollywood, CA
National Provider Identifier
1982155701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT33865TLG
- Practice address
- 6765 Lankershim Blvd
North Hollywood, CA 91606 - Phone
- (818) 982-0076
- Fax
- (818) 982-0634
- NPI assigned
- Oct 17, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1839-773AT | LA | |
| Optometrist | 152W00000X | OPT33865TLG | CA | Primary |
Addresses
Primary practice location
6765 Lankershim Blvd
North Hollywood, CA 91606
Mailing address
6765 Lankershim Blvd
North Hollywood, CA 91606-1614
Phone (818) 982-0076
Other practice location 1
477 E Colorado Blvd
Pasadena, CA 91101-2024
Phone (626) 796-1191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPT33865TLG | Other | CA | BOARD OF OPTOMETRY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33865 | CA | MD | Chiropractor |
| OPT33865TLG | CA | MD | Optometrist |
| 1839-773AT | LA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert F. Collins | Optometrist | Past | Accepting new patients |
| Dr. Arlene T. Yepremian, O.D. a Professional Corporation | Optometrist | Past | Accepting new patients |
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.
-
- Clinic/Center
- Glendale, CA
- NPI 1043547482
Optometrist
-
- Optometrist
- North Hollywood, CA
- NPI 1205272820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1982155701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6765 LANKERSHIM BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916061614",
"telephone_number": "818-982-0076",
"fax_number": "818-982-0634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6765 LANKERSHIM BLVD",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "91606",
"telephone_number": "818-982-0076",
"fax_number": "818-982-0634"
}
],
"practiceLocations": [
{
"address_1": "477 E Colorado Blvd",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911012024",
"country_code": "US",
"telephone_number": "626-796-1191",
"fax_number": "626-796-0189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATHERNE",
"first_name": "MICHAEL",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-17",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "LA",
"license": "1839-773AT",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT33865TLG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF OPTOMETRY",
"identifier": "OPT33865TLG",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.