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SAMANTHA MAKPAIBOONVATANA
NPI 1043703564
Optometrist in San Bernardino, CA

Active since June 09, 2018PECOS EnrolledAccepts Medicare Assignment
1909 N WATERMAN AVE STE 3, SAN BERNARDINO, CA 92404(909) 882-8883 Get Directions Write a Review

NPPES record last updated: July 4, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 4, 2021, Oct 7, 2019, Oct 2, 2019 and 3 more (6 updates tracked since 2018).

About Samantha Makpaiboonvatana NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA MAKPAIBOONVATANA (NPI 1043703564) is an individual optometrist in San Bernardino, California, licensed in California (33980TLG) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2018).

NPPES Registry Identity

NPI1043703564
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameSAMANTHA MAKPAIBOONVATANA
Location Address1909 N WATERMAN AVE STE 3San Bernardino, CA 92404
Mailing Address1909 N Waterman Ave Ste 3San Bernardino, CA 92404-4842
Phone(909) 882-8883
Sole ProprietorNo
Medical School CMSSouthern California College Of OptometryGraduated 2018
Enumeration DateJune 9, 2018
Last NPPES UpdateJuly 4, 20216 updates tracked since enumeration
NPPES CertifiedJuly 4, 2021
✔ NPI 1043703564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 33980TLG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1909 N WATERMAN AVE STE 3, San Bernardino, CA 92404
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Makpaiboonvatana is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901148733
PECOS Enrollment IDI20190716000784
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92404 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GINTIEN HUANG MD INC
Ophthalmology
1909 N WATERMAN AVE STE 3
SAN BERNARDINO, CA 92404
San Bernardino County (908) 882-8829

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Makpaiboonvatana's NPI number?

The NPI number for Samantha Makpaiboonvatana is 1043703564. It was assigned to this individual provider in the NPPES registry on June 9, 2018.

Where is Samantha Makpaiboonvatana located?

Samantha Makpaiboonvatana practices at 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404. The listed phone number is (909) 882-8883.

What is Samantha Makpaiboonvatana's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Samantha Makpaiboonvatana enrolled in Medicare?

Yes. Samantha Makpaiboonvatana is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samantha Makpaiboonvatana accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Samantha Makpaiboonvatana as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Makpaiboonvatana was last updated on July 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.