NPIMap

Individual provider Active NPI

Theresa M. Cervinski, O.D.

  • Optometrist
  • Riverside, CA
National Provider Identifier
1336218445
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13242 Issued in CA
Practice address
19530 Van Buren Blvd
G8
Riverside, CA 92508-9455
Phone
(951) 656-0500
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2562ATI OR
Vision Therapy Optometrist 152WV0400X 2562ATI OR
Optometrist 152W00000X 639 NV
Optometrist 152W00000X 13242 CA Primary

Addresses

Primary practice location

19530 Van Buren Blvd
G8
Riverside, CA 92508-9455

Mailing address

19530 Van Buren Blvd
G8
Riverside, CA 92508-9455
Phone (951) 656-0500

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
2562ATIORMDOptometrist
639NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bradford G. Murray, O.D., a Professional Corp. Past Accepting new patients
Advanced Family Vision Center Optometry Optometrist PastSince Oct 1, 2012 Accepting new patients
James S Shin OD a Professional Optometrist PastSince Dec 21, 2015 Accepting new patients
Reed Eyecare, PC Optometrist PastSince Dec 29, 2024 Accepting new patients

Organizations & group practices 4

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1336218445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19530 VAN BUREN BLVD",
            "address_2": "G8",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089455",
            "telephone_number": "951-656-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19530 VAN BUREN BLVD",
            "address_2": "G8",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089455",
            "telephone_number": "951-656-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVINSKI",
        "first_name": "THERESA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2562ATI",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "2562ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "639",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.