Thomas Riggio, O.D.
Individual provider Active NPI Optometrist · Cool, CA
NPI 1104252147 · NPPES record last updated May 27, 2020
Key facts
- NPI
- 1104252147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 14774 (CA)
- Practice address
- 5020 Ellinghouse Dr
Ste a
Cool, CA 95614-9569 - Phone
- (530) 887-8048
- Fax
- (877) 721-2722
- NPI assigned
- Sep 23, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5020 Ellinghouse Dr
Suite a
Cool, CA 95614-9569
Phone (530) 887-8048
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150108000175 | CA | Practitioner - Optometry | 8022239375 |
Reassigns benefits to 2 organizations Practice locations: Cool, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14774 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra Eyecare Associates | Optometrist | Current |
Accepting new patients |
| Sierra Eyecare Associates | Optometrist | Current |
Accepting new patients |
Locations
817 Court St
Ste 10
Jackson, CA 95642
Phone (209) 223-2020
4 Jean St
Ste 1
Valley Springs, CA 95252
Phone (209) 772-9798
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14774 | CA | Yes |
Addresses
Primary practice location
5020 Ellinghouse Dr
Ste a
Cool, CA 95614-9569
Mailing address
5020 Ellinghouse Dr
Ste a
Cool, CA 95614-9569
Phone (530) 333-1730
Other practice location 1
5020 Ellinghouse Dr Ste A
Cool, CA 95614
Phone (530) 887-8048
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6121840 | Medicaid | CA |
Other providers in Cool, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.