Individual provider Active NPI

Donald Robert Zvanut, OD

  • Optometrist
  • La Mesa, CA
National Provider Identifier
1336211804
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8642TPG Issued in CA
Practice address
7339 El Cajon Blvd Ste JK
La Mesa, CA 91942-7435
Phone
(661) 972-2846
Fax
(619) 722-8465
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X U51564 CA
Optometrist 152W00000X 8642TPG CA Primary

Addresses

Primary practice location

7339 El Cajon Blvd Ste JK
La Mesa, CA 91942-7435

Mailing address

225 W Madison Ave
Suite 1
El Cajon, CA 92020
Phone (619) 442-0844

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
I20200424002014 CA Practitioner - Optometry 6800226226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5565 Grossmont Ctr Dr
Suite 551
La Mesa, CA 91942-3078
Phone (619) 465-2020

7339 El Cajon Blvd
Suite a
La Mesa, CA 91942-7435
Phone (619) 722-8460

9850 Genesee Ave
La Jolla, CA 92037-1208
Phone (858) 457-3010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
8642TPGCAMDOptometrist
U51564CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Institute of California Medical Group, a California Medical Par Optometrist CurrentSince Mar 11, 2020 Accepting new patients
Barry a. Katzman, M.D., Inc Apc Optometrist Past Accepting new patients
Retina Institute of California Medical Group, a California Medical Par Optometrist PastSince Oct 15, 2023 Accepting new patients

Locations

288 N Santa Anita Ave
Ste 101
Arcadia, CA 91006

9500 Stockdale Hwy
Ste 108
Bakersfield, CA 93311
Phone (661) 663-8500

11525 Brookshire Ave
Downey, CA 90241
Phone (562) 861-0954

225 W Madison Ave
Ste 1
El Cajon, CA 92020
Phone (619) 327-0146

7339 El Cajon Blvd
Ste J
La Mesa, CA 91942
Phone (619) 668-6200

7339 El Cajon Blvd
La Mesa, CA 91942
Phone (619) 668-1515

7339 El Cajon Blvd
Ste Jk
La Mesa, CA 91942
Phone (619) 722-8460

7339 El Cajon Blvd
Ste A
La Mesa, CA 91942
Phone (619) 722-8460

100 E California Blvd
Pasadena, CA 91105
Phone (626) 568-8838

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1336211804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W MADISON AVE",
            "address_2": "SUITE 1",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92020",
            "telephone_number": "619-442-0844",
            "fax_number": "619-442-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7339 EL CAJON BLVD STE JK",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427435",
            "telephone_number": "661-972-2846",
            "fax_number": "619-722-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZVANUT",
        "first_name": "DONALD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "U51564",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8642TPG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.