Individual provider Active NPI

Roger F Carlson, MD

  • Ophthalmology Physician
  • Vallejo, CA
National Provider Identifier
1336195486
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
00G231060 Issued in CA
Practice address
2852 Redwood Pkwy
Vallejo, CA 94591-3633
Phone
(707) 553-8222
Fax
(707) 553-1154
NPI assigned
May 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 00G231060 CA Primary

Addresses

Primary practice location

2852 Redwood Pkwy
Vallejo, CA 94591-3633

Mailing address

2852 Redwood Pkwy
Vallejo, CA 94591-3633
Phone (707) 553-8222

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ80657ZMedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080821000217 CA Practitioner - Ophthalmology 6507937596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00G231060CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redwood Eye Center Ophthalmology CurrentSince Feb 2, 2004 Accepting new patients

Locations

2852 Redwood Pkwy
Vallejo, CA 94591
Phone (707) 553-8222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336195486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 REDWOOD PKWY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945913633",
            "telephone_number": "707-553-8222",
            "fax_number": "707-553-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2852 REDWOOD PKWY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945913633",
            "telephone_number": "707-553-8222",
            "fax_number": "707-553-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ROGER",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "00G231060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ80657Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.