Individual provider Active NPI

Rebecca L NG, OD

  • Optometrist
  • San Clemente, CA
National Provider Identifier
1235297284
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT5189 Issued in CA
Practice address
653 Camino de Los Mares
Suite 107
San Clemente, CA 92673-2808
Phone
(949) 489-2218
Fax
(949) 496-3604
NPI assigned
Dec 4, 2006
Last updated
Aug 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT5189 CA Primary

Addresses

Primary practice location

653 Camino de Los Mares
Suite 107
San Clemente, CA 92673-2808

Mailing address

653 Camino de Los Mares
Suite 107
San Clemente, CA 92673-2808
Phone (949) 489-2218

Other identifiers 2

IdentifierTypeStateIssuer
410015394OtherRAILROAD MEDICARE
SD0051890MedicaidCA

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
I20080215000414 CA Practitioner - Optometry 0547343444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ramin Tayani MD IncGroup PAC ID 3274541826, 15 clinicians

Practice addresses (Care Compare)

653 Camino de Los Mares
Suite 103
San Clemente, CA 92673-2808
Phone (949) 489-2218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT5189CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ramin Tayani MD Inc CurrentSince Jan 14, 2012 Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Thomas S Tooma M D a Professional Corporation Optometrist PastSince Mar 12, 2023 Accepting new patients
Jan S Lukac MD Inc Past Accepting new patients
Vision Center LP PastSince Mar 14, 2017 Accepting new patients

Locations

380 W Central Ave
Ste 300
Brea, CA 92821
Phone (714) 529-9563

22 Odyssey
Ste 150
Irvine, CA 92618
Phone (949) 733-3390

25200 La Paz Rd
Ste 100
Laguna Hills, CA 92653

25200 La Paz Rd
Laguna Hills, CA 92653

653 Camino de los Mares
Ste 107
San Clemente, CA 92673
Phone (949) 489-2210

653 Camino de los Mares
Ste 103
San Clemente, CA 92673
Phone (949) 485-1333

653 Camino de los Mares
San Clemente, CA 92673

3301 S Harbor Blvd
Ste 104
Santa Ana, CA 92704
Phone (714) 979-2021

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rebecca.ng.p1@direct.tayani.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1235297284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES",
            "address_2": "SUITE 107",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-489-2218",
            "fax_number": "949-496-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES",
            "address_2": "SUITE 107",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-489-2218",
            "fax_number": "949-496-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT5189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410015394",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0051890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.