Individual provider Active NPI

Todd Jeffrey Harter, O.D.

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1063573673
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7809T Issued in CA
Practice address
2451 Summerfield Rd
Santa Rosa, CA 95405-7815
Phone
(707) 526-4050
Fax
(707) 569-1366
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7809T CA Primary

Addresses

Primary practice location

2451 Summerfield Rd
Santa Rosa, CA 95405-7815

Mailing address

2451 Summerfield Rd
Santa Rosa, CA 95405-7815
Phone (707) 526-4050

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
I20040108001145 CA Practitioner - Optometry 6406756337 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7309CAMDSocial Worker
7809TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley J Sandler MD Inc CurrentSince Nov 28, 2018 Accepting new patients
Bradley J Sandler MD Inc Optometrist CurrentSince Nov 28, 2018 Accepting new patients

Locations

1345 Gateway Blvd
Fairfield, CA 94533
Phone (707) 422-6500

1360 Burton Dr
Ste 150
Vacaville, CA 95687
Phone (707) 422-6500

Interoperability endpoints

  • Direct secure messaging: tharter@directaddress.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1063573673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 SUMMERFIELD RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057815",
            "telephone_number": "707-526-4050",
            "fax_number": "707-569-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 SUMMERFIELD RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057815",
            "telephone_number": "707-526-4050",
            "fax_number": "707-569-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTER",
        "first_name": "TODD",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7809T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.