Individual provider Active NPI

Todd Dana Severin, M.D.

  • Ophthalmology Physician
  • San Ramon, CA
National Provider Identifier
1144225343
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
OG711830 Issued in CA
Practice address
5801 Norris Canyon Rd
Ste 200
San Ramon, CA 94583-5406
Phone
(925) 830-8823
Fax
(925) 866-6610
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0009X G71183 CA
Ophthalmology Physician 207W00000X OG711830 CA Primary

Addresses

Primary practice location

5801 Norris Canyon Rd
Ste 200
San Ramon, CA 94583-5406

Mailing address

5801 Norris Canyon Rd
Ste 200
San Ramon, CA 94583-5440
Phone (925) 830-8823

Other identifiers 4

IdentifierTypeStateIssuer
180046438OtherCARAIL ROAD MEDICARE
ZZZ057067OtherCABLUE CROSS
OGP164916MedicaidCA
ZZZ05706ZOtherCABLUE SHIELD

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080609000779 CA Practitioner - Ophthalmology 9133225261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, San Diego School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay Eye Centers Medical CorporationGroup PAC ID 1951290709, 6 clinicians

Practice addresses (Care Compare)

5801 Norris Canyon Rd
Suite 200
San Ramon, CA 94583-5440
Phone (925) 830-8823

Merit-based Incentive Payment System (MIPS)

Final score
71.88 of 100Reported as group
Quality
97.21
Improvement activities
40
Cost
10

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
71183CAMDPharmacist
OG711830CAMDOphthalmology Physician
G71183CAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Eye Centers Medical Corporation Multi-Specialty CurrentSince Jun 18, 2008 Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
John Muir Health Past Accepting new patients
Hayward Sisters Hospital Past Accepting new patients
Berkeley California Optometric, Inc Multi-Specialty PastSince Oct 13, 2016 Accepting new patients

Locations

1313 Solano Ave
Albany, CA 94706
Phone (510) 526-0194

8440 Brentwood Blvd
Ste D
Brentwood, CA 94513
Phone (925) 634-0303

5801 Norris Canyon Rd
Ste 200
San Ramon, CA 94583
Phone (925) 830-8823

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tseverin@ebec.intellechartdirect.net

Organizations & group practices 6

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1144225343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NORRIS CANYON RD",
            "address_2": "STE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835440",
            "telephone_number": "925-830-8823",
            "fax_number": "925-866-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NORRIS CANYON RD",
            "address_2": "STE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835406",
            "telephone_number": "925-830-8823",
            "fax_number": "925-866-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERIN",
        "first_name": "TODD",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "CA",
            "license": "G71183",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "OG711830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "180046438",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ057067",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OGP164916",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ05706Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.