Organization Active NPI

Tom Eye Care LLC

  • Optometrist
  • Kaneohe, HI
National Provider Identifier
1184041527
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TOM EYE CARE LLC
Practice address
45-955 Kamehameha Hwy
Room 104
Kaneohe, HI 96744-3222
Phone
(808) 247-3063
Fax
(808) 235-4973
NPI assigned
Mar 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Authorized official

Name
Dr. Taylor G.M. Tom, O.D.NPI 1669548400
Title
Owner
Phone
(808) 247-3063

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 HI Primary

Addresses

Primary practice location

45-955 Kamehameha Hwy
Room 104
Kaneohe, HI 96744-3222

Mailing address

45-955 Kamehameha Hwy
Room 104
Kaneohe, HI 96744-3222
Phone (808) 247-3063

Other identifiers 2

IdentifierTypeStateIssuer
56349601MedicaidHI
05133601MedicaidHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150410000678 HI Part B Supplier - Clinic/Group Practice 4688992266 Receives reassigned benefits from 1 practitioner
Practice locations: Kaneohe, HI

National Provider Directory

National Provider Directory
Tax ID family
Dr Dewey WK Tom OD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

45-955 Kamehameha Hwy
Ste 104
Kaneohe, HI 96744
Phone (808) 247-3063

Practitioners & affiliated clinicians

Practitioners 1

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": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1184041527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-955 KAMEHAMEHA HWY",
            "address_2": "ROOM 104",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443222",
            "telephone_number": "808-247-3063",
            "fax_number": "808-235-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-955 KAMEHAMEHA HWY",
            "address_2": "ROOM 104",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443222",
            "telephone_number": "808-247-3063",
            "fax_number": "808-235-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "TOM",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "G.M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-247-3063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56349601",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05133601",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.