NPIMap

Organization Active NPI

First Optometric Care of Northern California PC

Doing business as Eastgate Optometry Care

  • Optometrist
  • Garden Grove, CA
National Provider Identifier
1033704507
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC
Doing business as
Eastgate Optometry Care
Practice address
11893 Valley View St
Garden Grove, CA 92845-1236
Phone
(714) 373-2020
NPI assigned
Mar 5, 2021
Last updated
Jul 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
James Ernest WinnickNPI 1821171000
Title
Owner
Phone
(209) 847-3051

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

11893 Valley View St
Garden Grove, CA 92845-1236

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (916) 858-5656

Other names 1

  • Eastgate Optometry Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210608000773 CA Part B Supplier - Clinic/Group Practice 6002216488 Receives reassigned benefits from 26 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cupertino, CA; Fair Oaks, CA; Modesto, CA; Norwalk, CA; Palo Alto, CA; Pinole, CA; Rancho Cordova, CA; Redwood City, CA…

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1033704507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985",
            "telephone_number": "916-858-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11893 VALLEY VIEW ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928451236",
            "telephone_number": "714-373-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "WINNICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-847-3051"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastgate Optometry Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastgate Optometry Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.