Individual provider Active NPI

Adam Todd Rosa, OD

  • Optometrist
  • Oceanside, CA
National Provider Identifier
1295250264
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34093LTG Issued in CA
Practice address
3915 Mission Ave
Ste 2
Oceanside, CA 92058-7801
Phone
(760) 757-8771
Fax
(760) 757-3073
NPI assigned
Aug 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34093LTG CA Primary

Addresses

Primary practice location

3915 Mission Ave
Ste 2
Oceanside, CA 92058-7801

Mailing address

9591 Graham St Apt 28
Cypress, CA 90630-3836
Phone (831) 676-7003

Other practice location 1

10800 N Port Washington Rd
Mequon, WI 53092-5007
Phone (262) 241-4848

Other practice location 2

120 Martin Dr
Fredonia, WI 53021-9455
Phone (262) 692-9000

Other practice location 3

8693 N Port Washington Rd
Fox Point, WI 53217-2209
Phone (414) 351-2020

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
I20190108002407 CA Practitioner - Optometry 2163797572 Reassigns benefits to 2 organizations
I20191009001851 CA Practitioner - Optometry 2163797572 Practice locations: Oceanside, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adam Rosa OD IncGroup PAC ID 7517342348, 3 clinicians

Practice addresses (Care Compare)

3915 Mission Ave
Suite 2
Oceanside, CA 92058-7801
Phone (760) 757-8771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34093CAMDHealth Psychologist
34093LTGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Rosa OD Inc Optometrist CurrentSince Aug 1, 2022 Accepting new patients
North Coast Optometry Optometrist PastSince Sep 1, 2019 Accepting new patients

Locations

711 Grand Ave
Ste 2
Carlsbad, CA 92008
Phone (760) 729-4327

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295250264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9591 GRAHAM ST APT 28",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303836",
            "telephone_number": "831-676-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 MISSION AVE",
            "address_2": "STE 2",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587801",
            "telephone_number": "760-757-8771",
            "fax_number": "760-757-3073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530925007",
            "country_code": "US",
            "telephone_number": "262-241-4848",
            "fax_number": "262-241-9865",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Martin Dr",
            "address_purpose": "LOCATION",
            "city": "Fredonia",
            "state": "WI",
            "postal_code": "530219455",
            "country_code": "US",
            "telephone_number": "262-692-9000",
            "fax_number": "262-692-2797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8693 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Fox Point",
            "state": "WI",
            "postal_code": "532172209",
            "country_code": "US",
            "telephone_number": "414-351-2020",
            "fax_number": "414-351-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSA",
        "first_name": "ADAM",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34093LTG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.