Pacific Vision Institute Surgical Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G79065 Issued in CA

Legal business name

PACIFIC VISION INSTITUTE SURGICAL INC

Practice address

1 Daniel Burnham CT Ste 170C
San Francisco, CA 94109-0455

Phone

(415) 922-9500

Fax

(415) 922-9568

NPI assigned

Mar 26, 2008

Organization subpart

No

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

Authorized official

Name

Jamie R Gibeaut

Title

Practice Administrator

Phone

(415) 922-9500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 7

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

• Barry Scott Seibel, M.D.

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1992719124

  CA, Ophthalmology

  Medicare reassignment Care Compare group NPD
• Ella Faktorovich, M.D.

  • Ophthalmology Physician
  • San Francisco, CA
  • NPI 1013042266

  CA

  Medicare reassignment Care Compare group
• Andres Sebastian Parra, MD

  • Ophthalmology Physician
  • San Francisco, CA
  • NPI 1871097451

  Ophthalmology

  NPD
• Patricia Bainter, MD

  • Ophthalmology Physician
  • La Jolla, CA
  • NPI 1487737847

  Ophthalmology

  NPD (past)
• Bhavna Kodira

  • Optometrist
  • San Francisco, CA
  • NPI 1043179252
  NPD (past)
• Steve H Chang, M.D.

  • Ophthalmology Physician
  • Reno, NV
  • NPI 1801986625

  Ophthalmology

  NPD (past)
• Victor M Chin, M.D.

  • Ophthalmology Physician
  • Olympia, WA
  • NPI 1174553010

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1295907673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DANIEL BURNHAM CT STE 170C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941090455",
            "telephone_number": "415-922-9500",
            "fax_number": "415-922-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DANIEL BURNHAM CT STE 170C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941090455",
            "telephone_number": "415-922-9500",
            "fax_number": "415-922-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC VISION INSTITUTE SURGICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "GIBEAUT",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "415-922-9500"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G79065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Specialist Surgical Center LLC
• Pacific State Medical Group of California, P.C.
• Pacific Therx Inc
• Pacific Vision Eye Institute, a Medical Corporation
• Pacific Vision Foundation
• Pacific Vision Surgery Center LLC
• Pacific Womens Obstetrics & Gynecology Medical Group Inc
• Pacifica Psychology
• Pacifica Sfo LLC
• Katy L Pacino

• All providers in San Francisco, CA
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.