NPIMap

Organization Active NPI

First Optometric Care of Northern California PC

  • Optometrist
  • Fair Oaks, CA
National Provider Identifier
1295320778
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC
Practice address
11733 Fair Oaks Blvd
Fair Oaks, CA 95628-2816
Phone
(916) 966-6080
NPI assigned
Mar 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Christopher Crump
Title
Director of Operations
Phone
(571) 866-1887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

11733 Fair Oaks Blvd
Fair Oaks, CA 95628-2816

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (916) 851-4073

Other names 1

  • Oak Tree Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210608000773 CA Part B Supplier - Clinic/Group Practice 6002216488 Receives reassigned benefits from 26 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cupertino, CA; Fair Oaks, CA; Modesto, CA; Norwalk, CA; Palo Alto, CA; Pinole, CA; Rancho Cordova, CA; Redwood City, 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
Brookside Optometric Group12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1295320778",
    "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",
            "telephone_number": "916-851-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11733 FAIR OAKS BLVD",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282816",
            "telephone_number": "916-966-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "CRUMP",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "571-866-1887"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Tree Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.