Individual provider Active NPI

Darlene Kristine Matejka McMorris, O.D.

  • Optometrist
  • Redlands, CA
National Provider Identifier
1568448140
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11183T Issued in CA
Practice address
1478 Industrial Park Ave
Redlands, CA 92374-2892
Phone
(909) 793-2106
Fax
(909) 792-3246
NPI assigned
Dec 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11183T CA Primary

Addresses

Primary practice location

1478 Industrial Park Ave
Redlands, CA 92374-2892

Mailing address

1478 Industrial Park Ave
Redlands, CA 92374-2892
Phone (909) 793-2106

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
I20090625000081 CA Practitioner - Optometry 9436200847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1020 Nevada St
Suite 202
Redlands, CA 92374-2956
Phone (909) 793-2106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11183TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Redlands Optometry Group Inc a Professional Optometric Corporation Optometrist CurrentSince Apr 16, 2009 Accepting new patients

Locations

1020 Nevada St
Ste 202
Redlands, CA 92374
Phone (909) 793-2106

1478 Industrial Park Ave
Redlands, CA 92374
Phone (909) 793-2106

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1568448140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 INDUSTRIAL PARK AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742892",
            "telephone_number": "909-793-2106",
            "fax_number": "909-792-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 INDUSTRIAL PARK AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742892",
            "telephone_number": "909-793-2106",
            "fax_number": "909-792-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEJKA MCMORRIS",
        "first_name": "DARLENE",
        "middle_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11183T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.