Active NPI
Richard Kenneth Simonds, O.D.
- Optometrist
- Hemet, CA
National Provider Identifier
1710988027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT9091TLG
- Practice address
- 3601 W Florida Ave
Hemet, CA 92545-3514 - Phone
- (951) 652-3072
- Fax
- (951) 766-4244
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | OPT9091TLG | CA | Primary |
Addresses
Primary practice location
3601 W Florida Ave
Hemet, CA 92545-3514
Mailing address
3601 W Florida Ave
Hemet, CA 92545-3514
Phone (951) 652-3072
Other practice location 1
6755 Mira Mesa Blvd
Suite 141
San Diego, CA 92121-4392
Phone (858) 535-8282
Other practice location 2
6755 Mira Mesa Blvd
Suite 141
San Diego, CA 92121-4392
Phone (858) 535-8282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0090912 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT9091TLG | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Tony D Pham OD Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Eyewear Supplier
- National City, CA
- NPI 1982758546
-
- Optometrist
- San Diego, CA
- NPI 1760672315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1710988027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 W FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925453514",
"telephone_number": "951-652-3072",
"fax_number": "951-766-4244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925453514",
"telephone_number": "951-652-3072",
"fax_number": "951-766-4244"
}
],
"practiceLocations": [
{
"address_1": "6755 Mira Mesa Blvd",
"address_2": "Suite 141",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921214392",
"country_code": "US",
"telephone_number": "858-535-8282",
"fax_number": "858-535-0537",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6755 Mira Mesa Blvd",
"address_2": "Suite 141",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921214392",
"country_code": "US",
"telephone_number": "858-535-8282",
"fax_number": "858-535-0537",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMONDS",
"first_name": "RICHARD",
"middle_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT9091TLG",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0090912",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.