Bryan J Mirone Optometric Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BRYAN J MIRONE OPTOMETRIC INC

Practice address

4000 Tyler St
Riverside, CA 92503-3458

Phone

(951) 687-7100

Fax

(951) 687-1663

NPI assigned

Mar 26, 2020

Last updated

Mar 26, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan Joseph Mirone, ODNPI 1174938963

Title

President

Phone

(951) 901-9644

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan Mirone

  • Optometrist
  • Riverside, CA
  • NPI 1174938963
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1851928063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033458",
            "telephone_number": "951-687-7100",
            "fax_number": "951-687-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033458",
            "telephone_number": "951-687-7100",
            "fax_number": "951-687-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN J MIRONE OPTOMETRIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "MIRONE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-901-9644",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooklynn Brumley
• Ron Nelson Brunelle, B.A.,CADC,II
• Amy Nicole Bruno, BA
• Luna E Bruno
• Teralyn Riggs Brusca, RN
• Madelynn Bryan, MOTR/L
• Bryant & Larson. a Professional Dental Corporation (Larson Orthodontics)
• Jasmine Bryant
• Stephanie Bryant
• Javon Douglass Bryson, HIGH SCHOOL DIPLOMA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.