Active NPI
Joseph Gergis Botrus, OD
- Optometrist
- Pomona, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT35741-TLG
- Practice address
- 309 E 2ND St
Pomona, CA 91766-1854 - Phone
- (909) 623-6116
- NPI assigned
- Jun 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist | 152WV0400X | OPT35741-TLG | CA | |
| Optometrist | 152W00000X | OPT35741-TLG | CA | Primary |
Addresses
Primary practice location
309 E 2ND St
Pomona, CA 91766-1854
Mailing address
471 Mandeville Dr
Walnut, CA 91789-4719
Phone (626) 466-7086
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
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4515 Central Ave
Suite 101
Riverside, CA 92506-2374
Phone (951) 784-2420
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT35741-TLG | CA | MD | Vision Therapy Optometrist |
| 35741 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western University of Health Sciences | Optometrist | Current | Accepting new patients |
| Western University of Health Sciences | Current | Accepting new patients | |
| Western University of Health Sciences | Current | Accepting new patients | |
| Total Vision PC | Optometrist | Current | Accepting new patients |
Locations
27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691
795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877
795 E 2nd St
Ste 2
Pomona, CA 91766
Phone (909) 469-8673
309 E 2nd St
Pomona, CA 91766
Phone (909) 469-5589
4515 Central Ave
Ste 101
Riverside, CA 92506
Phone (909) 784-2420
Organizations & group practices 4
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.
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- NPI 1356813711
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- Family Medicine Physician
- Pomona, CA
- NPI 1679515217
-
- Optometrist
- Pomona, CA
- NPI 1245467885
-
- Pharmacy
- Pomona, CA
- NPI 1295051779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1174366090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471 MANDEVILLE DR",
"city": "WALNUT",
"state": "CA",
"postal_code": "917894719",
"telephone_number": "626-466-7086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-623-6116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTRUS",
"first_name": "JOSEPH",
"middle_name": "GERGIS",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "CA",
"license": "OPT35741-TLG",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT35741-TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.