Richard Vandyke Packard, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9332 Issued in CA

Practice address

74927 US Highway 111
Indian Wells, CA 92210

Phone

(760) 568-2340

Fax

(866) 529-1713

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Southern College of Optometry, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Trilogy Eye Medical Group Inc

  • Ophthalmology Physician
  • Pasadena, CA
  • NPI 1114205432

  Optometrist

  NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1942358320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74927 US HIGHWAY 111",
            "city": "INDIAN WELLS",
            "state": "CA",
            "postal_code": "922107136",
            "telephone_number": "760-568-2340",
            "fax_number": "866-529-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74927 US HIGHWAY 111",
            "city": "INDIAN WELLS",
            "state": "CA",
            "postal_code": "92210",
            "telephone_number": "760-568-2340",
            "fax_number": "866-529-1713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45655 Oasis St",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922014564",
            "country_code": "US",
            "telephone_number": "760-347-5191",
            "fax_number": "760-347-9301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "RICHARD",
        "middle_name": "VANDYKE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "9332TPA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Nguyen, RPH
• Jimmy Quoc Nam Nguyen
• Tran Nguyen
• Barbara Ann Norman, NP-C
• Brigid Norton, M.D.
• Laura G Padron, APN
• Palm Springs Recovery Treatment Center
• Matilde Parente, MD
• Ronald Paul Portnoff, MD
• Vicki Portnoff, M.D.

• Optometrist in Indian Wells, CA
• Providers in Indian Wells, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.