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DR. DAMON MATTHEW ELLIS O.D. NPI 1023231917


NPI Information

NPI: 1023231917
Provider Name: DR. DAMON MATTHEW ELLIS, O.D.
Classification: Optometrist - 152W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3205 GRAND AVE
OAKLAND, CA
ZIP 94610
Phone: (510) 444-0666
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DR. Damon Matthew Ellis, O.D. is an optometrist in Oakland, CA with 22 years of experience. The provider is 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. DR. Damon Matthew Ellis, O.D. NPI is 1023231917. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduation Year:2002

The provider's business location address is:

3205 GRAND AVE
OAKLAND, CA
ZIP 94610-740
Phone: (510) 444-0666

The NPI 1023231917 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/10/2007 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist11878TCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1SD0018780MEDICAIDCALIFORNIA
2U99562MEDICARE UPINCALIFORNIA
3SD0018780MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.