Active NPI
Andrew Gore, O.D.
- Optometrist
- Pasadena, CA
National Provider Identifier
1376513259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11251T
- Practice address
- 301 E Colorado Blvd
#528
Pasadena, CA 91101-1915 - Phone
- (626) 796-5533
- Fax
- (626) 796-8954
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11251T | CA | Primary |
Addresses
Primary practice location
301 E Colorado Blvd
#528
Pasadena, CA 91101-1915
Mailing address
301 E Colorado Blvd
#528
Pasadena, CA 91101-1915
Phone (626) 796-5533
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051222000776 | CA | Practitioner - Optometry | 0840212437 | Practice locations: Pasadena, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
301 E Colorado Blvd
Pasadena, CA 91101-1974
Phone (626) 796-5533
301 E Colorado Blvd
Suite 528
Pasadena, CA 91101-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11251T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189382400000",
"number": "1376513259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E COLORADO BLVD",
"address_2": "#528",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011915",
"telephone_number": "626-796-5533",
"fax_number": "626-796-8954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E COLORADO BLVD",
"address_2": "#528",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011915",
"telephone_number": "626-796-5533",
"fax_number": "626-796-8954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORE",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2007-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11251T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.