Individual provider Active NPI

Garrett Scott Wada, OD

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1033172903
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10097T Issued in CA
Practice address
936 S Brookhurst St
Anaheim, CA 92804-4305
Phone
(714) 533-2525
Fax
(714) 242-9564
NPI assigned
Apr 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10097T CA Primary

Addresses

Primary practice location

936 S Brookhurst St
Anaheim, CA 92804-4305

Mailing address

936 S Brookhurst St
Anaheim, CA 92804-4305
Phone (714) 533-2525

Other identifiers 1

IdentifierTypeStateIssuer
SD010097MedicaidCA

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
I20040301001307 CA Practitioner - Optometry 6608763040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

936 S Brookhurst St
Anaheim, CA 92804-4305
Phone (714) 533-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10097TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wada Optometry, Inc. Optometrist CurrentSince Aug 4, 2014 Accepting new patients

Locations

936 S Brookhurst St
Anaheim, CA 92804
Phone (714) 533-2525

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1033172903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 S BROOKHURST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044305",
            "telephone_number": "714-533-2525",
            "fax_number": "714-242-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 S BROOKHURST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044305",
            "telephone_number": "714-533-2525",
            "fax_number": "714-242-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADA",
        "first_name": "GARRETT",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10097T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD010097",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.