Terry Whitesides Hawley, O.D.
Individual provider Active NPI Optometrist · Rolling Hills Estates, CA
NPI 1821139411 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821139411
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 6947T (CA)
- Practice address
- 827 Deep Valley Dr
Suite 311
Rolling Hills Estates, CA 90274-3647 - Phone
- (310) 541-3411
- Fax
- (310) 541-6678
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1980
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Palos Verdes Family Vision
Practice addresses (Care Compare)
827 Deep Valley Dr
Suite 311
Rolling Hills Estates, CA 90274-3655
Phone (310) 541-3411
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041209000367 | CA | Practitioner - Optometry | 7618933904 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6947T | CA | MD | Optometrist |
| 6947 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palos Verdes Family Vision | Optometrist | Current |
Accepting new patients |
Locations
827 Deep Valley Dr
Ste 311
Rolling Hills Estates, CA 90274
Phone (310) 540-3411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6947T | CA | Yes |
Addresses
Primary practice location
827 Deep Valley Dr
Suite 311
Rolling Hills Estates, CA 90274-3647
Mailing address
827 Deep Valley Dr
Suite 311
Rolling Hills Estates, CA 90274-3647
Phone (310) 541-3411
Other providers in Rolling Hills Estates, CA
- Melissa Marie Hammill
- Krystal Ly Han
- Shadi Hashemian
- C. Roger Hastings
- James Henry Hawley
- Kirstin Marie Hellmeyer
- Hemmat Health, PC
- Matin R Hemmat
- Laura E. Henson
- Erik Hernandez
All providers in Rolling Hills Estates, CA · Optometrist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.