Active NPI
Geovanny Rosas
- Student in an Organized Health Care Education/Training Program
- Garden Grove, CA
National Provider Identifier
1831995505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 11556 Kathy LN
Garden Grove, CA 92840-1719 - Phone
- (714) 473-7113
- NPI assigned
- Feb 21, 2025
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
11556 Kathy LN
Garden Grove, CA 92840-1719
Mailing address
11556 Kathy LN
Garden Grove, CA 92840-1719
Phone (714) 473-7113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern California College of Optometry, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12461 W Washington Blvd
Los Angeles, CA 90066-5511
Phone (310) 390-6287
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 and National Provider Directory roles.
-
- Optometrist
- San Diego, CA
- NPI 1356813711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1831995505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11556 KATHY LN",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928401719",
"telephone_number": "714-473-7113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11556 KATHY LN",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928401719",
"telephone_number": "714-473-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSAS",
"first_name": "GEOVANNY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-21",
"last_updated": "2025-02-21",
"certification_date": "2025-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.