Individual provider Active NPI

Eric T Ikeda, O.D.

  • Optometrist
  • Bellflower, CA
National Provider Identifier
1982700704
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8637T Issued in CA
Practice address
16816 Clark Avenue
Bellflower, CA 90706-5793
Phone
(562) 925-6591
Fax
(562) 867-8719
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8637T CA Primary

Addresses

Primary practice location

16816 Clark Avenue
Bellflower, CA 90706-5793

Mailing address

16816 Clark Avenue
Bellflower, CA 90706-5793
Phone (562) 925-6591

Other identifiers 1

IdentifierTypeStateIssuer
WY4402AOtherCAMEDICARE GROUP PIN

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
I20120713000294 CA Practitioner - Optometry 7517976400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16816 Clark Ave
Bellflower, CA 90706-5702
Phone (562) 925-6591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8637TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Vision Care Associates Inc Optometrist CurrentSince Jan 1, 1973 Accepting new patients

Locations

16816 Clark Ave
Bellflower, CA 90706
Phone (310) 925-6591

Organizations & group practices 1

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1982700704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16816 CLARK AVENUE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065793",
            "telephone_number": "562-925-6591",
            "fax_number": "562-867-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16816 CLARK AVENUE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065793",
            "telephone_number": "562-925-6591",
            "fax_number": "562-867-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDA",
        "first_name": "ERIC",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8637T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "WY4402A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

Verify at the official NPI Registry.