NPIMap

Organization Active NPI

Mercy Eye Care Medical Group Inc

  • Ophthalmology Physician
  • Whittier, CA
National Provider Identifier
1982926531
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A48969 Issued in CA
Legal business name
MERCY EYE CARE MEDICAL GROUP INC
Practice address
12480 Washington Blvd
Whittier, CA 90602-1005
Phone
(844) 211-5462
Fax
(562) 866-1803
NPI assigned
Feb 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Authorized official

Name
Dr. Sandeep Khanna, MDNPI 1366514044
Title
President
Phone
(844) 211-5462

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A48969 CA Primary

Addresses

Primary practice location

12480 Washington Blvd
Whittier, CA 90602-1005

Mailing address

1700 E Cesar E Chavez Ave Ste 3400
Los Angeles, CA 90033-2469
Phone (844) 211-5462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070605000712 CA Part B Supplier - Clinic/Group Practice 1951409572 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lakewood, CA; Los Angeles, CA; Montebello, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mercy Eye Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12480 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0241

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1982926531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE STE 3400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332469",
            "telephone_number": "844-211-5462",
            "fax_number": "562-866-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12480 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021005",
            "telephone_number": "844-211-5462",
            "fax_number": "562-866-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY EYE CARE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-211-5462",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A48969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.