Trevor Keith Irish, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13477T Issued in CA

Practice address

991 E Monte Vista Ave
Turlock, CA 95382-0636

Phone

(209) 634-8591

Fax

(209) 634-8596

NPI assigned

Aug 1, 2007

Last updated

Sep 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Southern California College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fifth Optometric Care of CaliforniaGroup PAC ID 4284096298, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/

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.

• Fifth Optometric Care of California

  • Optometrist
  • San Jose, CA
  • NPI 1215627914
  Medicare reassignment Care Compare group NPD
• Trevor K Irish OD Inc

  dba Monte Vista Optometry

  • Optometrist
  • Turlock, CA
  • NPI 1114249026
  Authorized official Same address or phone
• Fifth Optometric Care of California

  dba Monte Vista Optometry

  • Optometrist
  • Turlock, CA
  • NPI 1316787450
  NPD
• Fifth Optometric Care of California

  dba Taft Eye Care Optometric Center

  • Optometrist
  • Taft, CA
  • NPI 1699504746
  NPD
• Fifth Optometric Care of California

  dba Japantown Optometry

  • Optometrist
  • San Jose, CA
  • NPI 1871271353
  NPD (past)
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD (past)
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Tahlequah, OK
  • NPI 1093722324
  NPD (past)
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1790976066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 E MONTE VISTA AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953820636",
            "telephone_number": "209-634-8591",
            "fax_number": "209-634-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 E MONTE VISTA AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953820636",
            "telephone_number": "209-634-8591",
            "fax_number": "209-634-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRISH",
        "first_name": "TREVOR",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2533",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3257ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13477T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5033839",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "DB428A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Turlock, CA
• Providers in Turlock, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.

Verify at the official NPI Registry.