Active NPI
Gayle Ann Reis, OD
- Optometrist
- Redlands, CA
National Provider Identifier
1164484259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5009TPL
- Practice address
- 2050 W Redlands Blvd
Redlands, CA 92373-6228 - Phone
- (909) 792-3457
- Fax
- (909) 307-1863
- NPI assigned
- Apr 4, 2006
- 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 | 5009TPL | CA | Primary |
Addresses
Primary practice location
2050 W Redlands Blvd
Redlands, CA 92373-6228
Mailing address
363 Island Oak LN
Goleta, CA 93117-2478
Phone (909) 792-3457
Other practice location 1
627 E Florida Ave
Hemet, CA 92543-4383
Phone (951) 766-0599
Other practice location 2
4001 Hallmark Pkwy
San Bernardino, CA 92407-1876
Phone (909) 887-1881
Other practice location 3
58501 29 Palms Hwy
Yucca Valley, CA 92284-5765
Phone (760) 365-7350
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11108 | Other | CA | IEHP |
| SD0050090 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5009 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544745600000",
"number": "1164484259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "363 ISLAND OAK LN",
"city": "GOLETA",
"state": "CA",
"postal_code": "931172478",
"telephone_number": "909-792-3457",
"fax_number": "909-307-1863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 W REDLANDS BLVD",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923736228",
"telephone_number": "909-792-3457",
"fax_number": "909-307-1863"
}
],
"practiceLocations": [
{
"address_1": "627 E Florida Ave",
"address_purpose": "LOCATION",
"city": "Hemet",
"state": "CA",
"postal_code": "925434383",
"country_code": "US",
"telephone_number": "951-766-0599",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4001 Hallmark Pkwy",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924071876",
"country_code": "US",
"telephone_number": "909-887-1881",
"fax_number": "909-887-8557",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "58501 29 Palms Hwy",
"address_purpose": "LOCATION",
"city": "Yucca Valley",
"state": "CA",
"postal_code": "922845765",
"country_code": "US",
"telephone_number": "760-365-7350",
"fax_number": "760-228-2814",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REIS",
"first_name": "GAYLE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-04",
"last_updated": "2018-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5009TPL",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IEHP",
"identifier": "11108",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0050090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.