Individual provider Active NPI

Gaganjot Virk, OD

  • Optometrist
  • Davis, CA
National Provider Identifier
1326524638
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34204-TLG Issued in CA
Practice address
231 C St
Davis, CA 95616-4521
Phone
(530) 758-4000
Fax
(530) 758-4016
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34204-TLG CA Primary

Addresses

Primary practice location

231 C St
Davis, CA 95616-4521

Mailing address

231 C St
Davis, CA 95616-4521
Phone (530) 758-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250828003222 CA Practitioner - Optometry 3173876190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

231 C St
Davis, CA 95616-4521
Phone (530) 758-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34204CAMDChiropractor
008874NYMDRegistered Dietitian
34204-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis J Guerrieri OD Inc Optometrist CurrentSince Jun 9, 2024 Accepting new patients
Eye Sea Optometry Apc Optometrist CurrentSince Jun 1, 2025 Accepting new patients
5TH Ave Eye Care, Inc. PastSince Aug 18, 2019 Accepting new patients

Locations

231 C St
Davis, CA 95616
Phone (530) 758-4000

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1326524638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 C ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164521",
            "telephone_number": "530-758-4000",
            "fax_number": "530-758-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 C ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164521",
            "telephone_number": "530-758-4000",
            "fax_number": "530-758-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRK",
        "first_name": "GAGANJOT",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34204-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.