Individual provider Active NPI

Scott A Lewis, O.D.

  • Optometrist
  • Murrieta, CA
National Provider Identifier
1376640664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6729T Issued in CA
Practice address
24400 Jackson Ave
Suite a
Murrieta, CA 92562
Phone
(951) 677-5144
Fax
(951) 698-1892
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6729T CA Primary

Addresses

Primary practice location

24400 Jackson Ave
Suite a
Murrieta, CA 92562

Mailing address

24400 Jackson Ave Ste a
Murrieta, CA 92562-1987
Phone (951) 677-5144

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
I20081209000129 CA Practitioner - Optometry 6002977139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alex Tadros Optometric CorporationGroup PAC ID 6507250297, 5 clinicians

Practice addresses (Care Compare)

24640 Jefferson Ave
Suite 100
Murrieta, CA 92562-9030
Phone (951) 677-5144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6729TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott a Lewis Optometric Optometrist CurrentSince Jan 1, 1982 Accepting new patients
Alex Tadros Optometric Corporation Optometrist CurrentSince Jan 1, 2022 Accepting new patients

Locations

24640 Jefferson Ave
Murrieta, CA 92562
Phone (951) 600-9111

24640 Jefferson Ave
Ste 100
Murrieta, CA 92562
Phone (951) 677-5144

24400 Jackson Ave
Ste A
Murrieta, CA 92562
Phone (951) 677-5144

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376640664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24400 JACKSON AVE STE A",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925621987",
            "telephone_number": "951-677-5144",
            "fax_number": "951-698-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24400 JACKSON AVE",
            "address_2": "SUITE A",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "92562",
            "telephone_number": "951-677-5144",
            "fax_number": "951-698-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6729T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.