Individual provider Active NPI

Lorna P Reyes, O.D.

  • Optometrist
  • Cerritos, CA
National Provider Identifier
1316098999
Registry record updated Aug 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12611 Issued in CA
Practice address
11351 183Rd St
Cerritos, CA 90703-5434
Phone
(562) 925-0950
Fax
(562) 809-8566
NPI assigned
Jan 12, 2007
Last updated
Aug 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12611 CA Primary

Addresses

Primary practice location

11351 183Rd St
Cerritos, CA 90703-5434

Mailing address

425 W. Bonita Ave.
Suite 110B
San Dimas, CA 91773-2543
Phone (909) 394-0462

Other names 1

  • Lorna Madarang Former 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
I20040930001053 CA Practitioner - Optometry 7719956200 Reassigns benefits to 1 organization
Practice locations: Cerritos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12611CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpmotikonrca LLC CurrentSince Mar 30, 2016 Accepting new patients
Spectrum Eyecare Optometry Inc Optometrist CurrentSince Jun 6, 2015 Accepting new patients

Locations

425 W Bonita Ave
Ste 110B
San Dimas, CA 91773
Phone (909) 394-0462

1335 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (562) 867-0811

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1316098999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W. BONITA AVE.",
            "address_2": "SUITE 110B",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732543",
            "telephone_number": "909-394-0462",
            "fax_number": "909-394-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11351 183RD ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035434",
            "telephone_number": "562-925-0950",
            "fax_number": "562-809-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "LORNA",
        "middle_name": "P",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORNA",
            "last_name": "MADARANG",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.