Individual provider Active NPI

Eric Verret, OD

  • Optometrist
  • Escondido, CA
National Provider Identifier
1194891853
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11401T Issued in CA
Practice address
613 E Grand Ave
Escondido, CA 92025-4402
Phone
(760) 747-7979
Fax
(760) 747-7799
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11401T CA Primary

Addresses

Primary practice location

613 E Grand Ave
Escondido, CA 92025-4402

Mailing address

613 E Grand Ave
Escondido, CA 92025-4402
Phone (760) 747-7979

Other identifiers 1

IdentifierTypeStateIssuer
SD0114010MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512000575 CA Practitioner - Optometry 0143261859 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11401TCAMDOptometrist
11401CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Verret O.D., Inc CurrentSince Jan 18, 2019 Accepting new patients
Pomona Valley Optometry Inc Optometrist PastSince Apr 1, 2005 Accepting new patients

Locations

613 E Grand Ave
Escondido, CA 92025
Phone (760) 743-4616

Organizations & group practices 2

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1194891853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 E GRAND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254402",
            "telephone_number": "760-747-7979",
            "fax_number": "760-747-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 E GRAND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254402",
            "telephone_number": "760-747-7979",
            "fax_number": "760-747-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERRET",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11401T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0114010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.