NPIMap

Organization Active NPI

Third Optometric Care of California PC

Doing business as Antelope Mall Vision Center Optometry

  • Optometrist
  • Palmdale, CA
National Provider Identifier
1215824768
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
THIRD OPTOMETRIC CARE OF CALIFORNIA PC
Doing business as
Antelope Mall Vision Center Optometry
Practice address
40033 10TH St W Ste a
Palmdale, CA 93551-3016
Phone
(661) 265-0883
Fax
(661) 265-7515
NPI assigned
Jun 18, 2025
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Brittany Harrison
Title
Director, RCM
Phone
(512) 316-4603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

40033 10TH St W Ste a
Palmdale, CA 93551-3016

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985

Other names 1

  • Antelope Mall Vision Center Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210427002381 CA Part B Supplier - Clinic/Group Practice 8325456536 Receives reassigned benefits from 28 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Auburn, CA; Buena Park, CA; Elk Grove, CA; Irvine, CA; Ojai, CA; Palmdale, CA; Rancho Cordova, CA; Rialto, CA…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Antelope Mall Vision Center Optometry11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2131 Capitol Ave
Ste 107
Sacramento, CA 95816
Phone (916) 446-0125

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1215824768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40033 10TH ST W STE A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513016",
            "telephone_number": "661-265-0883",
            "fax_number": "661-265-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD OPTOMETRIC CARE OF CALIFORNIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "DIRECTOR, RCM",
        "authorized_official_telephone_number": "512-316-4603"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Antelope Mall Vision Center Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.