Active NPI
Grace J. Cortes-Stefanovic, O.D.
- Optometrist
- Corona, CA
National Provider Identifier
1871790212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 13247
- Practice address
- 480 N McKinley St
Corona, CA 92879-1291 - Phone
- (951) 279-1987
- NPI assigned
- Jun 29, 2007
- Last updated
- Sep 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 13247 | CA | Primary |
Addresses
Primary practice location
480 N McKinley St
Corona, CA 92879-1291
Mailing address
3060 Stable Way
Norco, CA 92860-5109
Phone (951) 966-9189
Other names 1
- Dr. Grace J. Cortes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13247 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients |
Organizations & group practices 2
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": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1871790212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3060 STABLE WAY",
"city": "NORCO",
"state": "CA",
"postal_code": "928605109",
"telephone_number": "951-966-9189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 N MCKINLEY ST",
"city": "CORONA",
"state": "CA",
"postal_code": "928791291",
"telephone_number": "951-279-1987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORTES-STEFANOVIC",
"first_name": "GRACE",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GRACE",
"last_name": "CORTES",
"middle_name": "J.",
"prefix": "DR.",
"credential": "O.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.