Kevin Randal Guck, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35267 Issued in CA

Practice address

653 Camino de Los Mares Ste 103
San Clemente, CA 92673-2808

Phone

(949) 489-2218

NPI assigned

Sep 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ramin Tayani MD IncGroup PAC ID 3274541826, 15 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kevin.guckod.p1@direct.tayani.nextgenshare.com

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.

• Ramin Tayani MD Inc

  • Ophthalmology Physician
  • San Clemente, CA
  • NPI 1841465986
  Medicare reassignment Care Compare group NPD
• Jan S Lukac MD Inc

  • Ophthalmology Physician
  • Brea, CA
  • NPI 1619964038
  NPD (past)
• Vision Center LP

  • Primary Care Clinic/Center
  • Santa Ana, CA
  • NPI 1942503933
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1356064075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES STE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-489-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES STE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-489-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUCK",
        "first_name": "KEVIN",
        "middle_name": "RANDAL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Renee Griffith, LCSW
• Sandra S Grifman, PHD MFC 12218
• Gruber Medical Corporation
• Nancy Elizabeth Guardado McDougall, PSY.D.
• Nicolette Gubicza, LMFT 121814
• Guiding Light
• Navjyot Gujral, M.D
• Vaishali Gursahani
• Karen Diane Guthrie, CD(DONA), HCHI
• H. Bronson Bassir DDS Inc

• Optometrist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.