Individual provider Active NPI

Tania Stevens, O.D.

  • Optometrist
  • Long Beach, CA
National Provider Identifier
1427089630
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12072 Issued in CA
Practice address
5724 E 7TH St
Long Beach, CA 90803-2002
Phone
(562) 986-6373
NPI assigned
Jul 5, 2006
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12072 CA Primary
Corneal and Contact Management Optometrist 152WC0802X 12072 CA
Low Vision Rehabilitation Optometrist 152WL0500X 12072 CA
Pediatric Optometrist 152WP0200X 12072 CA
Sports Vision Optometrist 152WS0006X 12072 CA
Vision Therapy Optometrist 152WV0400X 12072 CA

Addresses

Primary practice location

5724 E 7TH St
Long Beach, CA 90803-2002

Mailing address

5724 E 7TH St
Long Beach, CA 90803-2002
Phone (562) 986-6373

Other identifiers 1

IdentifierTypeStateIssuer
01899994MedicaidNY

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
I20130416000196 CA Practitioner - Optometry 4284547753 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wink Optometry del Mar IncGroup PAC ID 0345520623, 3 clinicians

Practice addresses (Care Compare)

2673 Via de la Valle
Suite F
Del Mar, CA 92014-1912
Phone (858) 755-9465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1202CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tania Stevens Optometrist PC Optometrist CurrentSince May 13, 2003 Accepting new patients
Wink Optometry del Mar Inc Optometrist CurrentSince Jul 12, 2024 Accepting new patients
Michael P de Carlo Optometrist Inc Low Vision Rehabilitation PastSince Jul 21, 2024 Accepting new patients
Sophie Poselle, Optometrist, P.C. Optometrist PastSince Mar 1, 2012 Accepting new patients

Locations

2673 Via de la Valle
Ste F
Del Mar, CA 92014
Phone (858) 454-4699

5724 E 7th St
Long Beach, CA 90803
Phone (562) 986-6373

12925 El Camino Real
Ste 203
San Diego, CA 92130
Phone (858) 348-5900

2365 Boston Post Rd
Ste 202
Larchmont, NY 10538
Phone (914) 834-2020

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1427089630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5724 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032002",
            "telephone_number": "562-986-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5724 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032002",
            "telephone_number": "562-986-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TANIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12072",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "12072",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "12072",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "12072",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "12072",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "12072",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01899994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.