Legacy Optometry - Medicare Optometrist in Susanville, CA

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Legacy Optometry is a medicare enrolled "Optometrist" provider in Susanville, California. Their current practice location is 600 Ash St, Susanville, California. You can reach out to their office (for appointments etc.) via phone at (530) 257-4424.

Legacy Optometry is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Legacy Optometry is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1326660960.

Contact Information

Legacy Optometry
600 Ash St,
Susanville, CA 96130-3714
(530) 257-4424
(530) 237-0426

Map and Direction




Healthcare Provider's Profile

Full NameLegacy Optometry
TypeFacility
SpecialityOptometrist
Location600 Ash St, Susanville, California
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1326660960
  • Provider Enumeration Date: 05/16/2020
  • Last Update Date: 12/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9335564970
  • Enrollment ID: O20200730000833

Medical Identifiers

Medical identifiers for Legacy Optometry such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1326660960NPI-NPPES
V33674OtherNVNORIDIAN
002516454MedicaidNV

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Legacy Optometry acts as a billing entity for following providers:
Provider NameJoseph Pruitt
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1477752913
PECOS PAC ID: 8921187477
Enrollment ID: I20080508000415
Provider NameAnika Ramolia
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1205084787
PECOS PAC ID: 0446398945
Enrollment ID: I20120222000284
Provider NameSheryl Reaves
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1023301280
PECOS PAC ID: 7315194826
Enrollment ID: I20120905000464
Provider NameKaren Mohar Sanghera
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1467884817
PECOS PAC ID: 0446477798
Enrollment ID: I20140808001673
Provider NameTeresa Pham
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1376685966
PECOS PAC ID: 7214249309
Enrollment ID: I20150702000010
Provider NameLilan Le
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1104230200
PECOS PAC ID: 9032413125
Enrollment ID: I20160210001606
Provider NameSamantha Vavricek
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1780036103
PECOS PAC ID: 1850689704
Enrollment ID: I20161010002184
Provider NameLinda Shi
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1700301231
PECOS PAC ID: 4688940679
Enrollment ID: I20180806000016
Provider NameMagdalena Fuentes
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1932617909
PECOS PAC ID: 3173864428
Enrollment ID: I20190415000573
Provider NameBradley Habermehl
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1356375463
PECOS PAC ID: 2365443314
Enrollment ID: I20191024002308
Provider NameAriel J Esquibel
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1023503810
PECOS PAC ID: 3678814613
Enrollment ID: I20191111001880
Provider NameTroy M Humphreys
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1992712194
PECOS PAC ID: 3779622006
Enrollment ID: I20200730000973
Provider NameJames Herzman
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1982764304
PECOS PAC ID: 8022168103
Enrollment ID: I20210126002509
Provider NameJenny Michelle Soo Hoo
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1124401427
PECOS PAC ID: 1850605767
Enrollment ID: I20210203002562
Provider NameHemali B. Jardosh
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1144537218
PECOS PAC ID: 6709066558
Enrollment ID: I20230228002055
Provider NameChristeen Min
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1275703068
PECOS PAC ID: 3173710837
Enrollment ID: I20230228002410
Provider NameDena Shahani
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1134533953
PECOS PAC ID: 8123404274
Enrollment ID: I20230315001609
Provider NameSelvin Gnanakkan
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1104980846
PECOS PAC ID: 1456317510
Enrollment ID: I20230316002551
Provider NameJennifer Gipp
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1154520666
PECOS PAC ID: 8729189899
Enrollment ID: I20230508001363
Provider NameMehreen Zia
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1093269524
PECOS PAC ID: 0042550238
Enrollment ID: I20231026002235
Provider NamePriscilla Lee
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1235126129
PECOS PAC ID: 5092790592
Enrollment ID: I20240223000453

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Legacy Optometry is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Legacy Optometry
600 Ash St,
Susanville, CA 96130-3714

Ph: (530) 257-4424		Legacy Optometry
600 Ash St,
Susanville, CA 96130-3714

Ph: (530) 257-4424

Reviews and Comments


Optometrist in Susanville, CA

Dr. Gregory A Boomer,
Optometrist
Medicare: Medicare Enrolled
Practice Location: 607 A Cottage St, Susanville, CA 96130
Phone: 530-257-4424    Fax: 530-257-9626
Dr. Martin G Hlusak, OD
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 914 Main St, Susanville, CA 96130
Phone: 530-257-2225    Fax: 530-257-2225
Richard Marason, O.D.
Optometrist
Medicare: Medicare Enrolled
Practice Location: 600 Ash St, Susanville, CA 96130
Phone: 530-257-3636    Fax: 530-257-7194

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.