Individual provider Active NPI

Robert Reiner

  • Optometrist
  • Carson, CA
National Provider Identifier
1285656793
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT4900TPA Issued in CA
Practice address
21739 S Avalon Blvd
Carson, CA 90745-3302
Phone
(310) 513-6900
Fax
(310) 513-1445
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT4900TPA CA Primary

Addresses

Primary practice location

21739 S Avalon Blvd
Carson, CA 90745-3302

Mailing address

21739 S Avalon Blvd
Carson, CA 90745-3302
Phone (310) 513-6900

Other identifiers 1

IdentifierTypeStateIssuer
SD0049000MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT4900TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert S Reiner Optometrist PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285656793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21739 S AVALON BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453302",
            "telephone_number": "310-513-6900",
            "fax_number": "310-513-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21739 S AVALON BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453302",
            "telephone_number": "310-513-6900",
            "fax_number": "310-513-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT4900TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0049000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.