Organization Active NPI

Bidwell Optometry

  • Optometrist
  • Folsom, CA
National Provider Identifier
1063724995
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6258T Issued in CA
Legal business name
BIDWELL OPTOMETRY
Practice address
2545 E Bidwell St
Suite 160
Folsom, CA 95630-6440
Phone
(916) 983-0896
Fax
(916) 983-0172
NPI assigned
Jul 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Dr. Thomas A. Jonas, O.D.
Title
President
Phone
(916) 983-0896

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 6258T CA Primary

Addresses

Primary practice location

2545 E Bidwell St
Suite 160
Folsom, CA 95630-6440

Mailing address

2545 E Bidwell St
Suite 160
Folsom, CA 95630-6440
Phone (916) 983-0896

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111119000004 CA Part B Supplier - Clinic/Group Practice 9739353558 Receives reassigned benefits from 2 practitioners
Practice locations: Folsom, CA

National Provider Directory

National Provider Directory

Locations

2545 E Bidwell St
Ste 160
Folsom, CA 95630
Phone (916) 983-0896

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1063724995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST",
            "address_2": "SUITE 160",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306440",
            "telephone_number": "916-983-0896",
            "fax_number": "916-983-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST",
            "address_2": "SUITE 160",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306440",
            "telephone_number": "916-983-0896",
            "fax_number": "916-983-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIDWELL OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "JONAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-983-0896",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6258T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.