Individual provider Active NPI

Monica Reyes, O.D.

  • Optometrist
  • Rancho Santa Margarita, CA
National Provider Identifier
1881029148
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT14642TLG Issued in CA
Practice address
22312 El Paseo Ste D
Rancho Santa Margarita, CA 92688-5803
Phone
(949) 589-6171
Fax
(949) 589-0657
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT14642TLG CA Primary

Addresses

Primary practice location

22312 El Paseo Ste D
Rancho Santa Margarita, CA 92688-5803

Mailing address

2709 W Pendleton Ave
Santa Ana, CA 92704-4921
Phone (714) 317-6853

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

LicenseStateTypeSpecialty
OPT14642TLGCAMDOptometrist
14642CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen M. Andersen, O.D., Inc. Optometrist PastSince Jan 18, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://kandersenod.ef.prod.fhir.ema-api.com/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1881029148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 W PENDLETON AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044921",
            "telephone_number": "714-317-6853",
            "fax_number": "888-477-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22312 EL PASEO STE D",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926885803",
            "telephone_number": "949-589-6171",
            "fax_number": "949-589-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MONICA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT14642TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.