Roushanak Fadavi, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

14103T Issued in CA

Practice address

4 Arcata
Mission Viejo, CA 92692-5138

Phone

(201) 725-9285

NPI assigned

Jan 25, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thomas S Tooma M D a Professional CorporationGroup PAC ID 7911004288, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Thomas S Tooma M D a Professional Corporation

  dba Nvision Eye Centers

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1922129865
  Medicare reassignment Care Compare group NPD
• Luis a Chanes M D Inc

  dba Eye Associates of Orange County

  • Specialist
  • Santa Ana, CA
  • NPI 1568481679
  Medicare reassignment NPD
• Thomas S Tooma M D a Professional Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1215583257
  NPD
• Thomas S. Tooma, M.D. a Professional Corporation

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1386764983
  NPD (past)

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1891033825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30212 TOMAS STE 170",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882174",
            "telephone_number": "949-589-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ARCATA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926925138",
            "telephone_number": "201-725-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAVI",
        "first_name": "ROUSHANAK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "14103T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Theodore Ezpeleta, ACSW
• F Awadalla MD PC (Skincredible Dermatology & Surgery)
• F Awadalla MD PC (Skincredible Dermatology & Surgery)
• F Lee Irwin Jr MD Inc
• Faculty Physicians and Surgeons of Llusm
• Amir Pooyan Faghfoory, M.D.
• Golshan Fahimi, MD
• Nadin Faidi, MD
• Faith Family Chiropractic, Inc.
• Javad Faith, D.C

• Corneal and Contact Management Optometrist in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.

Verify at the official NPI Registry.