Individual provider Active NPI

Michael Matherne, O.D.

  • Optometrist
  • North Hollywood, CA
National Provider Identifier
1982155701
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33865TLG Issued in CA
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

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
OPT33865TLGOtherCABOARD 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

LicenseStateTypeSpecialty
33865CAMDChiropractor
OPT33865TLGCAMDOptometrist
1839-773ATLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert F. Collins Optometrist PastSince Sep 15, 2019 Accepting new patients
Dr. Arlene T. Yepremian, O.D. a Professional Corporation Optometrist PastSince Jan 27, 2018 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.

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.

Verify at the official NPI Registry.