Individual provider Active NPI

Robert Anthony Turcios Jr., O.D.

  • Optometrist
  • Pleasant Hill, CA
National Provider Identifier
1124053152
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7077T Issued in CA
Practice address
61 Chilpancingo Pkwy
Pleasant Hill, CA 94523-1300
Phone
(925) 676-8365
Fax
(925) 676-3382
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7077T CA Primary
Corneal and Contact Management Optometrist 152WC0802X 7077T CA
Low Vision Rehabilitation Optometrist 152WL0500X 7077T CA
Pediatric Optometrist 152WP0200X 7077T CA
Sports Vision Optometrist 152WS0006X 7077T CA
Vision Therapy Optometrist 152WV0400X 7077T CA
Occupational Vision Optometrist 152WX0102X 7077T CA

Addresses

Primary practice location

61 Chilpancingo Pkwy
Pleasant Hill, CA 94523-1300

Mailing address

61 Chilpancingo Pkwy
Pleasant Hill, CA 94523-1300
Phone (925) 676-8365

Other identifiers 2

IdentifierTypeStateIssuer
SD0070770MedicaidCA
7077TOtherCASTATE LICENCE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101008000460 CA Practitioner - Optometry 4880704436 Practice locations: Pleasant Hill, CA
O20150205001334 CA DME Supplier - Physician - Optometrist 4284959669 Practice locations: Pleasant Hill, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

395 Civic Dr
Suite G
Pleasant Hill, CA 94523-1950
Phone (925) 676-8365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7077TCAMDLow Vision Rehabilitation Optometrist
7077CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Etwaru Eye Center Past Accepting new patients

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1124053152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 CHILPANCINGO PKWY",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231300",
            "telephone_number": "925-676-8365",
            "fax_number": "925-676-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CHILPANCINGO PKWY",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231300",
            "telephone_number": "925-676-8365",
            "fax_number": "925-676-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURCIOS JR.",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7077T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "7077T",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "7077T",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "7077T",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "7077T",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "7077T",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "7077T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0070770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "7077T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.