Individual provider Active NPI

Donny R. Broyles, O.D.

  • Optometrist
  • Temecula, CA
National Provider Identifier
1235269861
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10290T Issued in CA
Practice address
31685 US Highway 79 S
Suite a
Temecula, CA 92592-2872
Phone
(951) 302-5580
Fax
(951) 302-5581
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10290T CA Primary

Addresses

Primary practice location

31685 US Highway 79 S
Suite a
Temecula, CA 92592-2872

Mailing address

31573 Rancho Pueblo Rd
Ste 101
Temecula, CA 92592-4835
Phone (951) 302-5580

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
I20081119000792 CA Practitioner - Optometry 2466512587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

31573 Rancho Pueblo Rd
Suite 101
Temecula, CA 92592-4835
Phone (951) 302-5580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10290TCAMDOptometrist
10290CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
First Optometric Care of Northern California PC Optometrist Current Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
Total Vision PC Optometrist CurrentSince Apr 22, 2019 Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist PastSince Apr 22, 2019 Accepting new patients

Locations

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

31573 Rancho Pueblo Rd
Ste 101
Temecula, CA 92592
Phone (951) 302-5580

Organizations & group practices 5

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1235269861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31573 RANCHO PUEBLO RD",
            "address_2": "STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925924835",
            "telephone_number": "951-302-5580",
            "fax_number": "951-302-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31685 US HIGHWAY 79 S",
            "address_2": "SUITE A",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925922872",
            "telephone_number": "951-302-5580",
            "fax_number": "951-302-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "DONNY",
        "middle_name": "R.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10290T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.