Active NPI
Terilyn T Thach, O.D.
- Optometrist
- Escondido, CA
National Provider Identifier
1710030861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11456T
- Practice address
- 2419 E Valley Pkwy
Escondido, CA 92027-2932 - Phone
- (760) 729-4696
- NPI assigned
- Jan 20, 2007
- Last updated
- Jul 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11456T | CA | Primary |
Addresses
Primary practice location
2419 E Valley Pkwy
Escondido, CA 92027-2932
Mailing address
2419 E Valley Pkwy
Escondido, CA 92027-2932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1593639 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2419 E Valley Pkwy
Escondido, CA 92027-2932
Phone (760) 738-9931
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11456T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terilyn Thach, Inc | Optometrist | Current | Accepting new patients |
Locations
2419 E Valley Pkwy
Escondido, CA 92027
Phone (760) 729-4696
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, 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": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310688000000",
"number": "1710030861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2419 E VALLEY PKWY",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920272932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2419 E VALLEY PKWY",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920272932",
"telephone_number": "760-729-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACH",
"first_name": "TERILYN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-20",
"last_updated": "2011-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11456T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1593639",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.