Individual provider Active NPI

Colvert Romulo Gonzales, O.D.

  • Optometrist
  • Monterey, CA
National Provider Identifier
1043574197
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14682 Issued in CA
Practice address
757 Pacific St
Suite C-1
Monterey, CA 93940-2819
Phone
(831) 372-8181
Fax
(831) 372-7433
NPI assigned
Jul 3, 2012
Last updated
Jan 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14682 CA Primary

Addresses

Primary practice location

757 Pacific St
Suite C-1
Monterey, CA 93940-2819

Mailing address

757 Pacific St
Suite C-1
Monterey, CA 93940-2819
Phone (831) 372-8181

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
I20140513000948 CA Practitioner - Optometry 7719139377 Practice locations: Monterey, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

757 Pacific St
Suite C1
Monterey, CA 93940-2819
Phone (831) 372-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hattori Vision Optometry PastSince Feb 4, 2014 Accepting new patients

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1043574197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 PACIFIC ST",
            "address_2": "SUITE C-1",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939402819",
            "telephone_number": "831-372-8181",
            "fax_number": "831-372-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 PACIFIC ST",
            "address_2": "SUITE C-1",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939402819",
            "telephone_number": "831-372-8181",
            "fax_number": "831-372-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "COLVERT",
        "middle_name": "ROMULO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.