NPIMap

Organization Active NPI

North Bay Eye Associates, a Medical Corporation

Doing business as North Bay Eye Associates, Inc

  • Ophthalmology Physician
  • Healdsburg, CA
National Provider Identifier
1083890693
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTH BAY EYE ASSOCIATES, A MEDICAL CORPORATION
Doing business as
North Bay Eye Associates, Inc
Practice address
1310 Prentice Dr
Suite F
Healdsburg, CA 95448-3384
Phone
(707) 433-9475
Fax
(707) 431-2013
NPI assigned
Jan 14, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH BAY EYE ASSOCIATES, A MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kimberlee K Breslin
Title
Accounts Receivable Manager
Phone
(707) 588-7946

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X CA
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1310 Prentice Dr
Suite F
Healdsburg, CA 95448-3384

Mailing address

PO Box 11688
Santa Rosa, CA 95406-1688
Phone (707) 588-7946

Other names 1

  • North Bay Eye Associates, Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101221001193 CA DME Supplier - Physician - General SurgeryDME Supplier - Physician - OptometristDME Supplier - Optician 9436147980 Practice locations: Healdsburg, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
North Bay Eye Associates,a Med Corp1310 Prentice Dr, Healdsburg, CA 95448-5004(707) 588-7946 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Dec 9, 2005

National Provider Directory

National Provider Directory
Tax ID family
North Bay Eye Associate6 organizations share this tax ID, including this one
Part of
North Bay Eye Associate

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083890693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11688",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954061688",
            "telephone_number": "707-588-7946",
            "fax_number": "707-588-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PRENTICE DR",
            "address_2": "SUITE F",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483384",
            "telephone_number": "707-433-9475",
            "fax_number": "707-431-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY EYE ASSOCIATES, A MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BAY EYE ASSOCIATES, A MEDICAL CORPORATION",
        "enumeration_date": "2008-01-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BRESLIN",
        "authorized_official_first_name": "KIMBERLEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "707-588-7946"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Bay Eye Associates, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Healdsburg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.