NPIMap

Organization Active NPI

Vitreo-Retinal Medical Group, Inc

Doing business as Retinal Consultants Medical Group

  • Retina Specialist (Ophthalmology) Physician
  • Tracy, CA
National Provider Identifier
1326880642
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
VITREO-RETINAL MEDICAL GROUP, INC
Doing business as
Retinal Consultants Medical Group
Practice address
615 International Pkwy Ste 103
Tracy, CA 95377-8922
Phone
(209) 938-0496
Fax
(209) 951-5231
NPI assigned
Jun 7, 2024
Organization subpart
Yes
Parent organization
VITREO-RETINAL MEDICAL GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Dr. Joel Pearlman, MDNPI 1154430460
Title
President
Phone
(916) 514-5469

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
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

615 International Pkwy Ste 103
Tracy, CA 95377-8922

Mailing address

3 Park Center Dr Ste 210
Sacramento, CA 95825-8341
Phone (916) 514-5469

Other names 1

  • Retinal Consultants Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050427000951 CA Part B Supplier - Clinic/Group Practice 5799672275 Receives reassigned benefits from 23 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yuba City, CA; Tracy, CA; Fairfield, CA; Stockton, CA; Sacramento, CA; Roseville, CA; Merced, CA; Grass Valley, CA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Retinal Cons of Sacto12 organizations share this tax ID, including this one
Part of
Retinal Cons of Sacto

Other organizations with this tax ID 11

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

Locations

6660 Coyle Ave
Ste 330
Carmichael, CA 95608
Phone (916) 962-3112

2460 Beacon St
Chico, CA 95928
Phone (530) 899-2251

460 W East Ave
Ste 110
Chico, CA 95926
Phone (530) 899-2244

19 Ilahee Ln
Chico, CA 95973
Phone (530) 746-0711

9381 E Stockton Blvd
Ste 106
Elk Grove, CA 95624
Phone (916) 454-6191

159 Catherine Ln
Grass Valley, CA 95945
Phone (530) 273-6192

3185 M St
Ste 220
Merced, CA 95348
Phone (209) 549-8444

1400 Florida Ave
Ste 212
Modesto, CA 95350
Phone (209) 549-8444

615 International Pkwy
Ste 103
Tracy, CA 95377
Phone (209) 477-3007

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1326880642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PARK CENTER DR STE 210",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258341",
            "telephone_number": "916-514-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 INTERNATIONAL PKWY STE 103",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778922",
            "telephone_number": "209-938-0496",
            "fax_number": "209-951-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITREO-RETINAL MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VITREO-RETINAL MEDICAL GROUP, INC",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "PEARLMAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-514-5469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Retinal Consultants Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.