Garrett Pennell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34482 Issued in CA

Practice address

4130 La Jolla Village Dr Ste 300
La Jolla, CA 92037-1481

Phone

(858) 455-6800

NPI assigned

Jun 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, CA2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

89.49 of 100Reported as group

Quality

94.56

Improvement activities

40

Cost

72.21

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gpennell@directaddress.net

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.

• Gordon Schanzlin New Vision Institute, Inc. a Professional Medical Cor

  • Optometrist
  • San Diego, CA
  • NPI 1134573678
  Medicare reassignment NPD
• Eye Care Associates of SC LLC

  • Optometrist
  • Chapin, SC
  • NPI 1679046569
  NPD (past)

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1710415823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 LA JOLLA VILLAGE DR STE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371481",
            "telephone_number": "858-455-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 LA JOLLA VILLAGE DR STE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371481",
            "telephone_number": "858-455-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELL",
        "first_name": "GARRETT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2024-01-10",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petra Elizabeth Jans Pederson, MD, PHD
• Olivia Peduto, RD
• Avanee S Peel, M.D.
• Patrick James Penalosa
• Andrew Duncan Penn, RN, NP, CNS
• Penny Michele Abrams PHD
• Ryan Harrison Penticuff, M.D.
• Courtney Clay Peraza
• Veronica Perez Canabal, DC
• Ladera Nicole Perez Linn, PSYD

• Optometrist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.