Organization Active NPI

Fremont Family Eyecare

  • Optometrist
  • Hayward, CA
National Provider Identifier
1093858235
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10541T Issued in CA
Legal business name
FREMONT FAMILY EYECARE
Practice address
31119 Mission Blvd
Hayward, CA 94544-7603
Phone
(510) 471-1234
Fax
(510) 471-7414
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rosalia Saavedra, OD
Title
Partner
Phone
(510) 471-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10541T CA Primary

Addresses

Primary practice location

31119 Mission Blvd
Hayward, CA 94544-7603

Mailing address

31119 Mission Blvd
Hayward, CA 94544-7603
Phone (510) 471-1234

Other names 1

  • fairway park optometry center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624001684 CA Part B Supplier - Clinic/Group Practice 9436135183 Receives reassigned benefits from 2 practitioners
Practice locations: Hayward, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093858235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31119 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945447603",
            "telephone_number": "510-471-1234",
            "fax_number": "510-471-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31119 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945447603",
            "telephone_number": "510-471-1234",
            "fax_number": "510-471-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAAVEDRA",
        "authorized_official_first_name": "ROSALIA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "510-471-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10541T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "fairway park optometry center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.