Individual provider Active NPI

Beverly Bianes Pack, OD

  • Optometrist
  • Chula Vista, CA
National Provider Identifier
1285692756
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9841T Issued in CA
Practice address
374 East H St
Ste 1708
Chula Vista, CA 91910-7484
Phone
(619) 425-7990
Fax
(619) 425-7992
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9841T CA Primary

Addresses

Primary practice location

374 East H St
Ste 1708
Chula Vista, CA 91910-7484

Mailing address

374 East H St
Ste 1708
Chula Vista, CA 91910-7484
Phone (619) 425-7990

Other names 1

  • Beverly Bianes Professional name

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
I20060105000752 CA Practitioner - Optometry 5092738971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

374 E H St
Chula Vista, CA 91910-7484
Phone (619) 425-7990

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9841TCAMDOptometrist
9841CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Apr 22, 2019 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients
Bonita Point Family Optometry, Inc. Optometrist PastSince Jun 1, 2012 Accepting new patients

Locations

180 Otay Lakes Rd
Ste 201
Bonita, CA 91902
Phone (619) 267-2012

890 Eastlake Pkwy
Chula Vista, CA 91914
Phone (619) 427-0311

374 E H St
Ste 1708
Chula Vista, CA 91910
Phone (619) 425-7990

374 E H St
Chula Vista, CA 91910
Phone (619) 425-7990

890 Eastlake Pkwy
Ste 102
Chula Vista, CA 91914
Phone (619) 216-3937

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

8205 Santa Monica Blvd
Ste 15
West Hollywood, CA 90046
Phone (323) 650-0337

Organizations & group practices 3

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1285692756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 EAST H ST",
            "address_2": "STE 1708",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107484",
            "telephone_number": "619-425-7990",
            "fax_number": "619-425-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 EAST H ST",
            "address_2": "STE 1708",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107484",
            "telephone_number": "619-425-7990",
            "fax_number": "619-425-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANES PACK",
        "first_name": "BEVERLY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9841T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "BIANES",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.