Individual provider Active NPI

Richard Joseph Beck, OD

  • Optometrist
  • So Lake Tahoe, CA
National Provider Identifier
1811906597
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4685T Issued in CA
Practice address
2074 Lake Tahoe Blvd
Suite 2
So Lake Tahoe, CA 96150
Phone
(530) 541-2030
Fax
(530) 541-3947
NPI assigned
Aug 5, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4685T CA Primary

Addresses

Primary practice location

2074 Lake Tahoe Blvd
Suite 2
So Lake Tahoe, CA 96150

Mailing address

2074 Lake Tahoe Blvd
Suite 2
So Lake Tahoe, CA 96150
Phone (530) 541-2030

Other identifiers 2

IdentifierTypeStateIssuer
410015213OtherCARAILROAD MEDICARE
ZZZ75623ZOtherMEDICARE GROUP PROVIDER#

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
I20100519000784 CA Practitioner - Optometry 4284717661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4685TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Tahoe Eye Care Optometry Inc Optometrist CurrentSince Nov 16, 1972 Accepting new patients

Locations

2074 Lake Tahoe Blvd
Ste 2
South Lake Tahoe, CA 96150
Phone (530) 541-2030

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811906597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 LAKE TAHOE BLVD",
            "address_2": "SUITE 2",
            "city": "SO LAKE TAHOE",
            "state": "CA",
            "postal_code": "96150",
            "telephone_number": "530-541-2030",
            "fax_number": "530-541-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 LAKE TAHOE BLVD",
            "address_2": "SUITE 2",
            "city": "SO LAKE TAHOE",
            "state": "CA",
            "postal_code": "96150",
            "telephone_number": "530-541-2030",
            "fax_number": "530-541-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4685T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410015213",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER#",
            "identifier": "ZZZ75623Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in So Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.