Individual provider Active NPI

Ashley Nakamura, O.D.

  • Optometrist
  • San Dimas, CA
National Provider Identifier
1992251490
Registry record updated Apr 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33554-TLG Issued in CA
Practice address
425 W Bonita Ave Ste 110B
San Dimas, CA 91773-2543
Phone
(909) 394-0462
Fax
(909) 394-0014
NPI assigned
Aug 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33554-TLG CA Primary

Addresses

Primary practice location

425 W Bonita Ave Ste 110B
San Dimas, CA 91773-2543

Mailing address

8934 Trailridge Ave
Santee, CA 92071-2050

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
I20170629001701 CA Practitioner - Optometry 7012286313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Eyecare Optometry IncGroup PAC ID 5193821353, 8 clinicians

Practice addresses (Care Compare)

425 W Bonita Ave
Suite 110B
San Dimas, CA 91773-2541
Phone (909) 394-0462

Merit-based Incentive Payment System (MIPS)

Final score
71.38 of 100Reported as group
Quality
22.76
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33554-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpmotikonrca LLC CurrentSince Jun 1, 2017 Accepting new patients
Spectrum Eyecare Optometry Inc Optometrist CurrentSince Jun 1, 2017 Accepting new patients

Locations

425 W Bonita Ave
Ste 110B
San Dimas, CA 91773
Phone (909) 394-0462

1335 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (562) 867-0811

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680998400000",
    "number": "1992251490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8934 TRAILRIDGE AVE",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920712050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W BONITA AVE STE 110B",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732543",
            "telephone_number": "909-394-0462",
            "fax_number": "909-394-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2023-04-09",
        "certification_date": "2023-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33554-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.