Individual provider Active NPI

Rick T Iwai, O.D.

  • Optometrist
  • San Pedro, CA
National Provider Identifier
1023069424
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT7967TPA Issued in CA
Practice address
571 W 7TH Street
San Pedro, CA 90731-3115
Phone
(310) 831-1201
Fax
(310) 833-0698
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT7967TPA CA Primary

Addresses

Primary practice location

571 W 7TH Street
San Pedro, CA 90731-3115

Mailing address

571 W 7TH Street
San Pedro, CA 90731-3115
Phone (310) 831-1201

Other identifiers 1

IdentifierTypeStateIssuer
SDOO79670MedicaidCA

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
I20070605000190 CA Practitioner - Optometry 3072611730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.43 of 100Reported as group
Quality
91.88
Promoting interoperability
76
Improvement activities
40
Cost
76.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7967CAMDAddiction (Substance Use Disorder) Counselor
OPT7967TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
East-West Eye Institute a Medical Corporation CurrentSince Feb 1, 2020 Accepting new patients
East-West Eye Institute a Medical Corporation Optometrist CurrentSince Feb 1, 2020 Accepting new patients

Locations

571 W 7th St
San Pedro, CA 90731
Phone (310) 831-1201

23441 Madison St
Ste 120
Torrance, CA 90505
Phone (310) 370-3628

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1023069424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 W 7TH STREET",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313115",
            "telephone_number": "310-831-1201",
            "fax_number": "310-833-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 W 7TH STREET",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313115",
            "telephone_number": "310-831-1201",
            "fax_number": "310-833-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWAI",
        "first_name": "RICK",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT7967TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SDOO79670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.