Individual provider Active NPI

Garrett Tyler Milner, O.D.

  • Optometrist
  • Hercules, CA
National Provider Identifier
1073742219
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13780 Issued in CA
Practice address
1581 Sycamore Ave
Suite 10
Hercules, CA 94547-1700
Phone
(510) 799-7380
NPI assigned
Jul 9, 2009
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13780 CA Primary

Addresses

Primary practice location

1581 Sycamore Ave
Suite 10
Hercules, CA 94547-1700

Mailing address

1375 Sycamore Ave
Ste 150E
Hercules, CA 94547-5540
Phone (510) 799-7380

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
I20091119000659 CA Practitioner - Optometry 6002955606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

6155 Stoneridge Dr
Suite 100
Pleasanton, CA 94588-3365
Phone (925) 463-2150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Sep 4, 2020 Accepting new patients
Scott P Daly Santa Cruz Optometric Optometrist Past Accepting new patients
Robert M Theaker O D an Optometric Corporation Optometrist PastSince Oct 31, 2010 Accepting new patients
Dung Optometric Group Optometrist Past Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients
DRS. Liu & Longacre, Inc. Optometrist PastSince Apr 7, 2008 Accepting new patients
Scott P Daly Santa Cruz Optometric Optometrist Past Accepting new patients

Locations

1375 Sycamore Ave
Ste 150E
Hercules, CA 94547
Phone (510) 799-7380

233 N Santa Cruz Ave
Los Gatos, CA 95030
Phone (408) 354-9310

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

6155 Stoneridge Dr
Ste 100
Pleasanton, CA 94588
Phone (925) 463-2150

5515 Geary Blvd
San Francisco, CA 94121
Phone (415) 387-3553

904 Cedar St
Santa Cruz, CA 95060
Phone (408) 426-1050

Organizations & group practices 8

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1073742219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 SYCAMORE AVE",
            "address_2": "STE 150E",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945475540",
            "telephone_number": "510-799-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 SYCAMORE AVE",
            "address_2": "SUITE 10",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471700",
            "telephone_number": "510-799-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILNER",
        "first_name": "GARRETT",
        "middle_name": "TYLER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hercules, CA

Sources for this page

Verify at the official NPI Registry.