Individual provider Active NPI

Geoffrey Eric Reynolds, O.D.

  • Optometrist
  • Mililani, HI
National Provider Identifier
1164560769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0491 Issued in HI
Practice address
95-390 Kuahelani Ave
Mililani, HI 96789-1192
Phone
(808) 623-2866
Fax
(808) 623-7255
NPI assigned
Feb 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0491 HI Primary

Addresses

Primary practice location

95-390 Kuahelani Ave
Mililani, HI 96789-1192

Mailing address

95-390 Kuahelani Ave
Mililani, HI 96789-1192
Phone (808) 623-2866

Other identifiers 1

IdentifierTypeStateIssuer
223990OtherHIHMSA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20200402001100 HI Practitioner - Optometry 5496180507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ronald R. Reynolds, O.D., Inc.Group PAC ID 7113046467, 2 clinicians

Practice addresses (Care Compare)

95 -1249 Meheula Pkwy
Suite 137
Mililani, HI 96789-1788
Phone (808) 623-2866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0491HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald R. Reynolds, O.D., Inc. Optometrist CurrentSince Feb 26, 2020 Accepting new patients

Locations

95-390 Kuahelani Ave
Mililani, HI 96789
Phone (808) 621-8411

95-1249 Meheula Pkwy
Ste 137
Mililani, HI 96789
Phone (808) 623-2866

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164560769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95-390 KUAHELANI AVE",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891192",
            "telephone_number": "808-623-2866",
            "fax_number": "808-623-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-390 KUAHELANI AVE",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891192",
            "telephone_number": "808-623-2866",
            "fax_number": "808-623-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "GEOFFREY",
        "middle_name": "ERIC",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "0491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "223990",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mililani, HI

Sources for this page

Verify at the official NPI Registry.