Individual provider Active NPI

Romayne Teresa Swanson-Rose, O.D.

  • Optometrist
  • Paso Robles, CA
National Provider Identifier
1356401384
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7404-T Issued in CA
Practice address
612 13TH St
Suite a
Paso Robles, CA 93446-7208
Phone
(805) 239-1177
Fax
(805) 239-2678
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7404-T CA Primary

Addresses

Primary practice location

612 13TH St
Suite a
Paso Robles, CA 93446-7208

Mailing address

612 13TH St
Suite a
Paso Robles, CA 93446-7208
Phone (805) 239-1177

Other identifiers 1

IdentifierTypeStateIssuer
SD0074040MedicaidCA

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
I20101222000812 CA Practitioner - Optometry 6406069772 Practice locations: Paso Robles, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

612 13TH St a
Paso Robles, CA 93446-7209
Phone (805) 239-1177

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7404-TCAMDOptometrist
7404CAMDOccupational Therapist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1356401384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 13TH ST",
            "address_2": "SUITE A",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934467208",
            "telephone_number": "805-239-1177",
            "fax_number": "805-239-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 13TH ST",
            "address_2": "SUITE A",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934467208",
            "telephone_number": "805-239-1177",
            "fax_number": "805-239-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON-ROSE",
        "first_name": "ROMAYNE",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7404-T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0074040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

Verify at the official NPI Registry.