Individual provider Active NPI

Kyle R McCarthy, OD

  • Optometrist
  • Camarillo, CA
National Provider Identifier
1649756016
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT34000-TLG Issued in CA
Practice address
99 E Daily Dr
Camarillo, CA 93010-5823
Phone
(805) 482-8849
Fax
(805) 388-8516
NPI assigned
Jul 18, 2018
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X TLG34000 CA
Optometrist 152W00000X OPT34000-TLG CA Primary

Addresses

Primary practice location

99 E Daily Dr
Camarillo, CA 93010-5823

Mailing address

82 Calle Escalon
Camarillo, CA 93010-1709
Phone (805) 469-5210

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
I20190403001604 CA Practitioner - Optometry 0446591309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

99 E Daily Dr
Camarillo, CA 93010-5823
Phone (805) 482-8849

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT34000-TLGCAMDOptometrist
TLG34000CAMDOptometrist
34000CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McCarthy Optometric Group a Professional Corporation Optometrist CurrentSince Sep 2, 2022 Accepting new patients
M. Trinh Optometry Inc Optometrist CurrentSince Mar 16, 2019 Accepting new patients
Ronald L. Goldstein, O.D. Optometrist PastSince Mar 16, 2019 Accepting new patients

Locations

99 E Daily Dr
Camarillo, CA 93010
Phone (805) 482-8849

277 Hampshire Rd
Westlake Village, CA 91361
Phone (805) 495-4625

Organizations & group practices 3

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1649756016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 CALLE ESCALON",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101709",
            "telephone_number": "805-469-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E DAILY DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105823",
            "telephone_number": "805-482-8849",
            "fax_number": "805-388-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KYLE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "TLG34000",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT34000-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.