Individual provider Active NPI

Kailey Marshall, O.D.

  • Optometrist
  • Corona, CA
National Provider Identifier
1780065938
Registry record updated Jun 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15278 Issued in CA
Practice address
800 Magnolia Ave Ste 113
Corona, CA 92879-3123
Phone
(951) 737-7820
NPI assigned
Jun 13, 2015
Last updated
Jun 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15278 CA Primary

Addresses

Primary practice location

800 Magnolia Ave Ste 113
Corona, CA 92879-3123

Mailing address

800 Magnolia Ave Ste 113
Corona, CA 92879-3123
Phone (951) 737-7820

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
I20150722005623 CA Practitioner - Optometry 7618280488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 9830094275, 52 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8068

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 5, 2016 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2015 Accepting new patients
University of California Irvine Past Accepting new patients
Uci Ophthalmology Group Optometrist Past Accepting new patients
Dena M. Mintz, O.D., a Professional Corporation Optometrist PastSince Oct 18, 2006 Accepting new patients
University of California Irvine Past Accepting new patients
Alan Arabi O.D., Inc Optometrist PastSince Apr 23, 2016 Accepting new patients

Locations

850 Health Sciences Rd
Irvine, CA 92617
Phone (949) 824-0606

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434153600000",
    "number": "1780065938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAGNOLIA AVE STE 113",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793123",
            "telephone_number": "951-737-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAGNOLIA AVE STE 113",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793123",
            "telephone_number": "951-737-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KAILEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-13",
        "last_updated": "2015-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.