Organization Active NPI

Al Vincent D. Romero, O.D. Inc.

  • Optometrist
  • Riverside, CA
National Provider Identifier
1164837183
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12695T Issued in CA
Legal business name
AL VINCENT D. ROMERO, O.D. INC.
Practice address
9496 Magnolia Ave Ste 102
Riverside, CA 92503-3733
Phone
(951) 687-5312
NPI assigned
Jun 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Authorized official

Name
Dr. Al Vincent D Romero, ODNPI 1952429748
Title
President
Phone
(909) 753-7126

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 12695T CA Primary

Addresses

Primary practice location

9496 Magnolia Ave Ste 102
Riverside, CA 92503-3733

Mailing address

6593 Acey St
Corona, CA 92880-3476
Phone (909) 753-7126

Other names 1

  • The Optical Shoppe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141230001442 CA Part B Supplier - Clinic/Group Practice 4880917715 Receives reassigned benefits from 1 practitioner
Practice locations: Riverside, CA; Chino, CA

National Provider Directory

National Provider Directory

Locations

9496 Magnolia Ave
Ste 101
Riverside, CA 92503
Phone (818) 986-8215

3824 La Sierra Ave
Riverside, CA 92505
Phone (909) 359-3377

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1164837183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6593 ACEY ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928803476",
            "telephone_number": "909-753-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9496 MAGNOLIA AVE STE 102",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033733",
            "telephone_number": "951-687-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AL VINCENT D. ROMERO, O.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "AL VINCENT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-753-7126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12695T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Optical Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.