Pegah Raven, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

14492TLG Issued in CA

Practice address

2230 Lynn Rd Ste 102
Thousand Oaks, CA 91360-1920

Phone

(805) 495-0458

NPI assigned

Oct 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

88.24 of 100Reported as group

Quality

86.17

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: p.raven@direct.mesmg.com

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1447560388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 103010",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911890147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 LYNN RD STE 102",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601920",
            "telephone_number": "805-495-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVEN",
        "first_name": "PEGAH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004579",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14492TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Rasmussen, M.S. LMFT
• Teresa Anne Rattray, PH.D.
• Bridget Rau, NONE
• Jennifer Rau
• Kenneth Raven, PH.D.
• Sheila Ray, BA
• Raymond L Lam MD Inc
• Ahsan Syed Raza, D.D.S.
• Timothy Jerad Rearick, MD
• Rebel Distribution Corp

• Optometrist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.

Verify at the official NPI Registry.