NPIMap

Organization Active NPI

California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Oxnard, CA
National Provider Identifier
1013050343
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
CALIFORNIA RETINA CONSULTANTS
Practice address
2901 N Ventura Rd Ste 250
Oxnard, CA 93036-1133
Phone
(805) 983-8808
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Robert L Avery, MDNPI 1700985496
Title
Ceo
Phone
(805) 963-1648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

2901 N Ventura Rd Ste 250
Oxnard, CA 93036-1133

Mailing address

525 E Micheltorena St
Suite a
Santa Barbara, CA 93103-2254
Phone (805) 963-1648

Other practice location 1

1687 Erringer Rd Ste 104
Simi Valley, CA 93065-6509
Phone (805) 813-8899

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ60753ZOtherCABLUE SHIELD GROUP #
GR0091150MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001116 CA Part B Supplier - Clinic/Group Practice 6608860135 Receives reassigned benefits from 16 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Palmdale, CA; Westlake Village, CA; Valencia, CA; Simi Valley, CA; Santa Maria, CA; San Luis Obispo, CA; Paso Robles, CA; Oxnard, CA…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2160458California Retina Consultants2901 N Ventura Rd Ste 250, Oxnard, CA 93036Certificate of waiverJan 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
California Retina Consultants10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1013050343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MICHELTORENA ST",
            "address_2": "SUITE A",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931032254",
            "telephone_number": "805-963-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N VENTURA RD STE 250",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930361133",
            "telephone_number": "805-983-8808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1687 Erringer Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930656509",
            "country_code": "US",
            "telephone_number": "805-813-8899",
            "fax_number": "805-426-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALIFORNIA RETINA CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-963-1648",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP #",
            "identifier": "ZZZ60753Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.