DAVID D. RICHARDSON M.D. NPI 1578553921

Ophthalmology in San Marino, CA

NPI 1578553921 Individual Male Ophthalmology PECOS Enrolled Opted-Out Medicare CLIA Number 05D2054703 CLIA Certificate of Waiver

About DAVID RICHARDSON

David Richardson is a provider established in San Marino, California and his medical specialization is ophthalmology. The NPI number of David Richardson is 1578553921 and was assigned on October 2005. The practitioner's primary taxonomy code is 207W00000X with license number A062824 (CA). The provider is registered as an individual and his NPI record was last updated 7 years ago.

David Richardson is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

David Richardson is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. David Richardson opted out of Medicare effective on 01-01-2014 until 01-01-2022. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

The CLIA number of David D. Richardson M.d. is 05D2054703 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to David D. Richardson M.d. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1578553921

Provider Name DAVID D. RICHARDSON M.D.
Provider Location Address2020 HUNTINGTON DR SAN MARINO, CA 91108
Provider Mailing Address2020 HUNTINGTON DR SAN MARINO, CA 91108
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date10-26-2005
Last Update Date02-16-2015


Primary Taxonomy

Taxonomy Code207W00000X
ClassificationOphthalmology
TypeAllopathic & Osteopathic Physicians
License No.A062824
License StateCA
Taxonomy DescriptionAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Business Address

DAVID D. RICHARDSON M.D.
2020 HUNTINGTON DR
SAN MARINO, CA
ZIP 91108
Phone: (626) 289-7856
Fax: (626) 284-6532

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Mailing Address

DAVID D. RICHARDSON M.D.
2020 HUNTINGTON DR
SAN MARINO, CA
ZIP 91108
Phone: (626) 289-7856
Fax: (626) 284-6532



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
Opted-Out of MedicareYes
Opt-Out Effective Date01-01-2014
Opt-Out End Date01-01-2022
Eligible to Order and ReferYes
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1578553921 is:

CLIA Number05D2054703
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
180038511OTHER (01)
A62824MEDICARE ID-TYPE UNSPECIFIED (04)
A62824AOTHER (01)
G94760MEDICARE UPIN (02)

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1407984891DAVID D. RICHARDSON, M.D., INC.
Organization
Ophthalmology2020 HUNTINGTON DR
SAN MARINO, CA 91108
(626) 289-7856
1346254745 WILLIAM MICHAEL PRITCHARD O.D.
Individual
Optometrist2020 HUNTINGTON DR
SAN MARINO, CA 91108
(626) 289-7856

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.