NPIMap

Organization Active NPI

Regents of the University of California at Berkeley

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1306908058
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA AT BERKELEY
Practice address
230 Minor Hall
Berkeley, CA 94720-0001
Phone
(510) 642-0945
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Authorized official

Name
Patrick Richards
Title
Director of Clinic FP&a
Phone
(510) 664-4632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

230 Minor Hall
Berkeley, CA 94720-0001

Mailing address

200 Minor Hall
Berkeley, CA 94720-0001
Phone (510) 642-0945

Other identifiers 1

IdentifierTypeStateIssuer
GSD000370MedicaidCA

Other names 1

  • U.C. BERKELEY SCHOOL OF OPTOMETRY Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060221000349 CA Part B Supplier - Clinic/Group Practice 8628083110 Receives reassigned benefits from 91 practitioners
Practice locations: Berkeley, CA

National Provider Directory

National Provider Directory

Locations

230 Minor Hall
Berkeley, CA 94720
Phone (510) 642-0609

2222 Bancroft Way
Fl 3
Berkeley, CA 94720
Phone (510) 642-9494

200 Minor Hall
Ste 384A
Berkeley, CA 94720
Phone (510) 642-7844

Practitioners & affiliated clinicians

Practitioners 125

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

View all 125

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1306908058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947200001",
            "telephone_number": "510-642-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947200001",
            "telephone_number": "510-642-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA AT BERKELEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC FP&A",
        "authorized_official_telephone_number": "510-664-4632"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD000370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.C. BERKELEY SCHOOL OF OPTOMETRY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "U.C. BERKELEY SCHOOL OF OPTOMETRY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.