Active NPI
Melody Deborah Tavakoli, O.D.
- Optometrist
- La Jolla, CA
National Provider Identifier
1154623254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14039
- Practice address
- 5702 La Jolla Blvd Ste 102
La Jolla, CA 92037-7322 - Phone
- (858) 800-2313
- Fax
- (858) 587-2600
- NPI assigned
- Nov 22, 2010
- Last updated
- Oct 19, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14039 | CA | Primary |
Addresses
Primary practice location
5702 La Jolla Blvd Ste 102
La Jolla, CA 92037-7322
Mailing address
4276 Mount Herbert Ave
San Diego, CA 92117-4723
Phone (818) 516-8753
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Melody Tavakoli O.D., Professional Corporation | Optometrist | Current | Accepting new patients |
| Seal Beach Eyes Optometry Inc | Optometrist | Past | Accepting new patients |
| Kelly Keane OD Professional Corporation | Optometrist | Past | Accepting new patients |
| Luxottica of America Inc | Past | Accepting new patients | |
| Steven T Klein OD & Kimberly Plattner OD a Professional Corporation | Optometrist | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Optometrist
- Chula Vista, CA
- NPI 1275912800
-
- Optometrist
- San Diego, CA
- NPI 1194240358
-
- Optometrist
- Seal Beach, CA
- NPI 1124171566
-
dba Total Vision Care Advanced Optometry
- Optometrist
- San Diego, CA
- NPI 1861529703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1792368000000",
"number": "1154623254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4276 MOUNT HERBERT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921174723",
"telephone_number": "818-516-8753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5702 LA JOLLA BLVD STE 102",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920377322",
"telephone_number": "858-800-2313",
"fax_number": "858-587-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVAKOLI",
"first_name": "MELODY",
"middle_name": "DEBORAH",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2026-10-19",
"certification_date": "2026-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.