Individual provider Active NPI

Erika Bray Ortega, O.D.

  • Optometrist
  • Modesto, CA
National Provider Identifier
1104001965
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13644 Issued in CA
Practice address
2401 E Orangeburg Ave Ste 280
Modesto, CA 95355-3396
Phone
(209) 525-8436
Fax
(209) 525-8438
NPI assigned
Dec 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13644 CA Primary

Addresses

Primary practice location

2401 E Orangeburg Ave Ste 280
Modesto, CA 95355-3396

Mailing address

2401 E Orangeburg Ave Ste 280
Modesto, CA 95355-3396
Phone (209) 525-8436

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
I20141211001047 CA Practitioner - Optometry 0547495517 Reassigns benefits to 1 organization
Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2401 E Orangeburg Ave
Suite 280
Modesto, CA 95355-3396
Phone (209) 525-8436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Works Optometry, Inc. Optometrist CurrentSince Jan 1, 2018 Accepting new patients

Locations

2401 E Orangeburg Ave
Ste 280
Modesto, CA 95355
Phone (209) 525-8436

Organizations & group practices 1

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": "1198886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1104001965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E ORANGEBURG AVE STE 280",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553396",
            "telephone_number": "209-525-8436",
            "fax_number": "209-525-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E ORANGEBURG AVE STE 280",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553396",
            "telephone_number": "209-525-8436",
            "fax_number": "209-525-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY ORTEGA",
        "first_name": "ERIKA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-29",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.