Individual provider Active NPI

Tonya R. Hubbard, OD

  • Optometrist
  • Reno, NV
National Provider Identifier
1275580896
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
942 Issued in NV
Practice address
18601 Wedge Parkway Suite 2C
Reno, NV 89511
Phone
(775) 358-1020
Fax
(775) 358-7951
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 256T WY
Optometrist 152W00000X 2069 CO
Optometrist 152W00000X 3585AT OR
Optometrist 152W00000X 942 NV Primary

Addresses

Primary practice location

18601 Wedge Parkway Suite 2C
Reno, NV 89511

Mailing address

1965 Baring Blvd
Sparks, NV 89434
Phone (775) 358-1020

Other identifiers 1

IdentifierTypeStateIssuer
54185351MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NV, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150917000292 OR Practitioner - Optometry 9133139850 Reassigns benefits to 1 organization
I20171228002401 NV Practitioner - Optometry 9133139850 Reassigns benefits to 2 organizations
I20250925000235 TX Practitioner - Optometry 9133139850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reno Sparks Indian ColonyGroup PAC ID 6507761897, 17 clinicians

Practice addresses (Care Compare)

1715 Kuenzli St
Reno, NV 89502-1117
Phone (775) 329-5162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2069COMDDental Hygienist
3585ATORMDOptometrist
256TWYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Reno Sparks Indian Colony CurrentSince Sep 1, 2024 Accepting new patients
Coffman Vision Clinic Inc Optometrist CurrentSince Jul 19, 2015 Accepting new patients
Michelle Wong Optometry PC Optometrist CurrentSince Sep 25, 2023 Accepting new patients

Locations

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

9700 S McCarran Blvd
Reno, NV 89523
Phone (775) 746-8884

1715 Kuenzli St
Reno, NV 89502
Phone (775) 329-5162

18601 Wedge Pkwy
Ste 2C
Reno, NV 89511
Phone (775) 358-1020

1965 Baring Blvd
Sparks, NV 89434
Phone (775) 358-1020

61535 S Highway 97
Ste 16
Bend, OR 97702
Phone (541) 389-4774

Organizations & group practices 4

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1275580896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 BARING BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "89434",
            "telephone_number": "775-358-1020",
            "fax_number": "775-358-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18601 WEDGE PARKWAY SUITE 2C",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-358-1020",
            "fax_number": "775-358-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "TONYA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "256T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2069",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3585AT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54185351",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.