Organization Active NPI

Pastore-Tran Eyecare, Inc.

  • Optometrist
  • Rockledge, FL
National Provider Identifier
1700979424
Registry record updated Apr 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3769 Issued in FL
Legal business name
PASTORE-TRAN EYECARE, INC.
Practice address
1285 US Highway 1
Rockledge, FL 32955-2711
Phone
(321) 639-2020
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2018

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

Authorized official

Name
Dr. Jacqueline Tran, O.D.
Title
Owner
Phone
(321) 639-2020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OPC3769 FL Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OPC3723 FL

Addresses

Primary practice location

1285 US Highway 1
Rockledge, FL 32955-2711

Mailing address

P.O. Box 560580
Rockledge, FL 32956-0580
Phone (321) 693-4124

Other identifiers 1

IdentifierTypeStateIssuer
003516800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803000562 FL Part B Supplier - Clinic/Group Practice 6103897277 Receives reassigned benefits from 2 practitioners
Practice locations: Melbourne, FL; Rockledge, FL

National Provider Directory

National Provider Directory

Locations

5500 Stadium Pkwy
Ste 102
Melbourne, FL 32940
Phone (321) 639-2020

1285 US Highway 1
Rockledge, FL 32955
Phone (321) 631-2811

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523750400000",
    "number": "1700979424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 560580",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560580",
            "telephone_number": "321-693-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 US HIGHWAY 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552711",
            "telephone_number": "321-639-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASTORE-TRAN EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-04-15",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-639-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3769",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3723",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003516800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.