Individual provider Active NPI

Jacqueline Tran-Pastore, O.D.

  • Optometrist
  • Rockledge, FL
National Provider Identifier
1932306792
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3769 Issued in FL
Practice address
1285 US Highway 1
Rockledge, FL 32955-2711
Phone
(321) 639-2020
NPI assigned
Jun 27, 2007
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3769 FL Primary

Addresses

Primary practice location

1285 US Highway 1
Rockledge, FL 32955-2711

Mailing address

PO Box 560580
Rockledge, FL 32956-0580

Other practice location 1

777 E Merritt Island Cswy
Merritt Island, FL 32952-3576
Phone (321) 459-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20040803000644 FL Practitioner - Optometry 7911978085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pastore-Tran Eyecare, Inc.Group PAC ID 6103897277, 2 clinicians

Practice addresses (Care Compare)

1000 N Wickham Rd
Melbourne, FL 32935-8937
Phone (321) 259-1699

5500 Stadium Pkwy
Suite 102
Melbourne, FL 32940-8095
Phone (321) 639-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3769FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pastore-Tran Eyecare, Inc. Optometrist CurrentSince Jun 14, 2004 Accepting new patients

Locations

1000 N Wickham Rd
Melbourne, FL 32935
Phone (321) 242-6037

5500 Stadium Pkwy
Ste 102
Melbourne, FL 32940
Phone (321) 639-2020

1285 US Highway 1
Rockledge, FL 32955
Phone (321) 631-2811

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, 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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1932306792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560580",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 US HIGHWAY 1",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552711",
            "telephone_number": "321-639-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 E Merritt Island Cswy",
            "address_purpose": "LOCATION",
            "city": "Merritt Island",
            "state": "FL",
            "postal_code": "329523576",
            "country_code": "US",
            "telephone_number": "321-459-1200",
            "fax_number": "321-454-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN-PASTORE",
        "first_name": "JACQUELINE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.