Individual provider Active NPI

Terry Metsovas, O.D.

  • Optometrist
  • Orange, CA
National Provider Identifier
1891874301
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT. 10460 TPA Issued in CA
Practice address
2097 N Tustin St
Orange, CA 92865-3901
Phone
(714) 637-9999
Fax
(714) 637-9993
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT. 10460 TPA CA Primary

Addresses

Primary practice location

2097 N Tustin St
Orange, CA 92865-3901

Mailing address

PO Box 6512
Orange, CA 92863-6512
Phone (714) 637-9999

Other identifiers 10

IdentifierTypeStateIssuer
5302020001OtherCADMERC
61327OtherCASAFEGUARD PPO
9358503OtherCAPHCS
207199OtherCAEYEMED VISION
61328OtherCASAFEGUARD HMO
CA10460OtherCAVISION BENEFITS AMERICA
SD01046T1OtherCABLUE SHIELD
13607OtherCAMEDICAL EYE SERVICE
19173OtherCACOAST TO COAST VISION
SD0104600MedicaidCA

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT. 10460 TPACAMDOptometrist
10460CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eyemax Optometry Inc Optometrist CurrentSince Aug 5, 2002 Accepting new patients

Locations

2097 N Tustin St
Orange, CA 92865
Phone (714) 637-9999

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891874301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6512",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928636512",
            "telephone_number": "714-637-9999",
            "fax_number": "714-637-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928653901",
            "telephone_number": "714-637-9999",
            "fax_number": "714-637-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METSOVAS",
        "first_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT. 10460 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5302020001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD PPO",
            "identifier": "61327",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9358503",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION",
            "identifier": "207199",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD HMO",
            "identifier": "61328",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION BENEFITS AMERICA",
            "identifier": "CA10460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "SD01046T1",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICE",
            "identifier": "13607",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COAST TO COAST VISION",
            "identifier": "19173",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0104600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.