Individual provider Active NPI

Linda Tannous, OD

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1235891763
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35020 Issued in CA
Practice address
2758 Macon Dr
Sacramento, CA 95835-2167
Phone
(916) 519-0669
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35020 CA Primary

Addresses

Primary practice location

2758 Macon Dr
Sacramento, CA 95835-2167

Mailing address

2758 Macon Dr
Sacramento, CA 95835-2167
Phone (916) 519-0669

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
I20230313002527 CA Practitioner - Optometry 6901294180 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avani Patel Optometric Corporation Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Hansra Optometric Corporation CurrentSince Jun 25, 2024 Accepting new patients
Tedder Optometric Corporation, PC Optometrist CurrentSince Jun 25, 2024 Accepting new patients

Locations

5345 Sunrise Blvd
Ste B
Fair Oaks, CA 95628
Phone (510) 731-7873

825 E Bidwell St
Ste 100
Folsom, CA 95630
Phone (279) 202-1202

4983 N Blackstone Ave
Fresno, CA 93726
Phone (510) 731-7873

23625 El Toro Rd
Ste E
Lake Forest, CA 92630
Phone (949) 227-2524

1208 Galleria Blvd
Ste 160
Roseville, CA 95678
Phone (279) 214-0170

1151 Galleria Blvd
Ste 175
Roseville, CA 95678
Phone (510) 731-7873

Organizations & group practices 3

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": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1235891763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2758 MACON DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958352167",
            "telephone_number": "916-519-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2758 MACON DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958352167",
            "telephone_number": "916-519-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNOUS",
        "first_name": "LINDA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.