Individual provider Active NPI

Robert J Moeser, O.D.

  • Optometrist
  • Tustin, CA
National Provider Identifier
1417927633
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7643T Issued in CA
Practice address
13011 Newport Ave
Suite #101
Tustin, CA 92780-3524
Phone
(714) 544-5282
Fax
(714) 544-5047
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 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 7643T CA Primary

Addresses

Primary practice location

13011 Newport Ave
Suite #101
Tustin, CA 92780-3524

Mailing address

13011 Newport Ave
Ste. #101
Tustin, CA 92780-3524
Phone (714) 544-5282

Other identifiers 1

IdentifierTypeStateIssuer
CH999AOtherCAMEDICARE PTAN

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
I20080604000402 CA Practitioner - Optometry 6507936408 Reassigns benefits to 1 organization
Practice locations: Tustin, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RDL Optometric ServicesGroup PAC ID 1456849181, 2 clinicians

Practice addresses (Care Compare)

13011 Newport Ave
Suite 101
Tustin, CA 92780-3516
Phone (714) 544-5282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7643TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
RDL Optometric Services Optometrist CurrentSince Sep 2, 2025 Accepting new patients

Locations

13011 Newport Ave
Ste 101
Tustin, CA 92780
Phone (714) 544-5282

Organizations & group practices 1

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1417927633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 NEWPORT AVE",
            "address_2": "STE. #101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803524",
            "telephone_number": "714-544-5282",
            "fax_number": "714-544-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13011 NEWPORT AVE",
            "address_2": "SUITE #101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803524",
            "telephone_number": "714-544-5282",
            "fax_number": "714-544-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOESER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7643T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  PTAN",
            "identifier": "CH999A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.