Individual provider Active NPI

Wynette Cook Augustine, O.D.

  • Optometrist
  • Placentia, CA
National Provider Identifier
1245205483
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7929T Issued in CA
Practice address
1201 N Rose Dr Ste 100
Placentia, CA 92870-3939
Phone
(714) 528-2566
Fax
(562) 988-7032
NPI assigned
Feb 21, 2006
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 226 NV
Optometrist 152W00000X 7929T CA Primary

Addresses

Primary practice location

1201 N Rose Dr Ste 100
Placentia, CA 92870-3939

Mailing address

1201 N Rose Dr Ste 100
Placentia, CA 92870-3939
Phone (714) 528-2566

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
I20060123001052 CA Practitioner - Optometry 0648294108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nusite OptometryGroup PAC ID 8123382884, 5 clinicians

Practice addresses (Care Compare)

1201 N Rose Dr
Suite 100
Placentia, CA 92870-3939
Phone (714) 528-2566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7929TCAMDOptometrist
7929CAMDAcupuncturist
226NVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Eyecare Optometry Inc . Optometrist CurrentSince Dec 3, 2023 Accepting new patients

Locations

1201 N Rose Dr
Ste 100
Placentia, CA 92870
Phone (714) 528-2566

Interoperability endpoints

  • Direct secure messaging: wynette.augustine@uprisedirect.com
  • Direct secure messaging: wynetteaugustine@hcpca.allscriptsdirect.net

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, 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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1245205483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N ROSE DR STE 100",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703939",
            "telephone_number": "714-528-2566",
            "fax_number": "714-993-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N ROSE DR STE 100",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703939",
            "telephone_number": "714-528-2566",
            "fax_number": "562-988-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "WYNETTE",
        "middle_name": "COOK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "226",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7929T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.