Teruo Watanabe, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5612T Issued in CA

Practice address

525 S Myrtle Ave Ste 107
Monrovia, CA 91016-6139

Phone

(626) 359-3937

Fax

(626) 358-5030

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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 California College of Optometry, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Teruo Watanabe OD IncGroup PAC ID 2365521697, 2 clinicians

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.

• Teruo Watanabe, O.D., Inc.

  • Optometrist
  • Monrovia, CA
  • NPI 1407957582
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1952402026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S MYRTLE AVE STE 107",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910166139",
            "telephone_number": "626-359-3937",
            "fax_number": "626-358-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S MYRTLE AVE STE 107",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910166139",
            "telephone_number": "626-359-3937",
            "fax_number": "626-358-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "TERUO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5612T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND. NPI",
            "identifier": "1952402026",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1285726877",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0056120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miles Washington
• Myeia Washington
• Shenaya Washington
• Sjrian Washington
• Alysa E. Watanabe, O.D.
• Jessica Waters Harris
• Brittney Waters
• Eric Waters
• Kelly Waters
• Lily Waters

• Optometrist in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.