Individual provider Active NPI

Ilya Nikolai Volk, OD

  • Optometrist
  • Encinitas, CA
National Provider Identifier
1285283275
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34343 Issued in CA
Practice address
477 N El Camino Real Ste C202
Encinitas, CA 92024-1332
Phone
(760) 631-3500
NPI assigned
Sep 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34343 CA Primary
Corneal and Contact Management Optometrist 152WC0802X 34343 CA

Addresses

Primary practice location

477 N El Camino Real Ste C202
Encinitas, CA 92024-1332

Mailing address

477 N El Camino Real Ste C202
Encinitas, CA 92024-1332

Other practice location 1

1930 Via Ctr
Vista, CA 92081-6056
Phone (760) 631-3500

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
I20191113002661 CA Practitioner - Optometry 9032541073 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34343CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fourth Optometric Care of California Optometrist CurrentSince May 14, 2023 Accepting new patients
Thomas S Tooma M D a Professional Corporation Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Fourth Optometric Care of California Optometrist CurrentSince May 14, 2023 Accepting new patients
Thomas S Tooma M D a Professional Corporation Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Fourth Optometric Care of California Optometrist Current Accepting new patients
North County Eye Center, Inc. Optometrist CurrentSince Nov 1, 2019 Accepting new patients

Locations

2653 Gateway Rd
Ste 101
Carlsbad, CA 92009
Phone (760) 476-1921

225 E 2nd Ave
Ste 310
Escondido, CA 92025
Phone (760) 738-9985

251 E 4th Ave
Escondido, CA 92025
Phone (760) 738-9985

15706 Pomerado Rd
Ste 103
Poway, CA 92064
Phone (858) 451-8600

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

3655 Nobel Dr
Ste 130
San Diego, CA 92122
Phone (858) 283-5371

Interoperability endpoints

  • Direct secure messaging: ilyanikolai.volkod.p1@direct.morriseyegroup.nextgenshare.com
  • Direct secure messaging: ivolk@nceyecenter.eyefinity-direct.com

Organizations & group practices 6

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1285283275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241332",
            "telephone_number": "760-631-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Via Ctr",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920816056",
            "country_code": "US",
            "telephone_number": "760-631-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLK",
        "first_name": "ILYA",
        "middle_name": "NIKOLAI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34343",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "34343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.