Individual provider Active NPI

Trajan Joaquin Soares, O.D.

  • Optometrist
  • Los Banos, CA
National Provider Identifier
1982609590
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT9569TPA Issued in CA
Practice address
1028 6TH St
Los Banos, CA 93635-4218
Phone
(209) 826-1434
Fax
(209) 826-8375
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT9569TPA CA Primary

Addresses

Primary practice location

1028 6TH St
Los Banos, CA 93635-4218

Mailing address

1028 6TH St
Los Banos, CA 93635-4218
Phone (209) 826-1434

Other identifiers 1

IdentifierTypeStateIssuer
SD0095690MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070501000610 CA Practitioner - Optometry 6305942715 Practice locations: Los Banos, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1028 6TH St
Los Banos, CA 93635-4218
Phone (209) 826-1434

Merit-based Incentive Payment System (MIPS)

Final score
58.38 of 100Reported as individual
Quality
16.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT9569TPACAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1982609590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 6TH ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354218",
            "telephone_number": "209-826-1434",
            "fax_number": "209-826-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 6TH ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354218",
            "telephone_number": "209-826-1434",
            "fax_number": "209-826-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES",
        "first_name": "TRAJAN",
        "middle_name": "JOAQUIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT9569TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0095690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.