NPIMap

Organization Active NPI

Farallon Eye Physicians Corp

  • Ophthalmology Physician
  • Daly City, CA
National Provider Identifier
1295887966
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G75139 Issued in CA
Legal business name
FARALLON EYE PHYSICIANS CORP
Practice address
1850 Sullivan Ave
Ste 500
Daly City, CA 94015-2215
Phone
(650) 992-9221
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Dr. Susan Longar, MDNPI 1578506960
Title
President
Phone
(650) 992-9221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G75139 CA Primary

Addresses

Primary practice location

1850 Sullivan Ave
Ste 500
Daly City, CA 94015-2215

Mailing address

1850 Sullivan Ave
Ste 500
Daly City, CA 94015-2221
Phone (650) 992-9221

Other identifiers 2

IdentifierTypeStateIssuer
180040517OtherCARAILROAD
GR0100800MedicaidCA

Other names 1

  • SUSAN LONGAR, M.D., A PROFESSIONAL CORPORATION Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720000501 CA Part B Supplier - Clinic/Group Practice 3375570443 Receives reassigned benefits from 4 practitioners
Practice locations: Daly City, CA

National Provider Directory

National Provider Directory

Locations

3000 Colby St
Ste 105
Berkeley, CA 94705
Phone (415) 202-1500

Practitioners & affiliated clinicians

Practitioners 5

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1295887966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "STE 500",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152221",
            "telephone_number": "650-992-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "STE 500",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152215",
            "telephone_number": "650-992-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARALLON EYE PHYSICIANS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "LONGAR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-992-9221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G75139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "180040517",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUSAN LONGAR, M.D., A PROFESSIONAL CORPORATION",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.