Shasta Eye Medical Group Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SHASTA EYE MEDICAL GROUP INC

Doing business as

Larkspur Optometry

Practice address

3190 Churn Creek Rd
Redding, CA 96002-2122

Phone

(530) 223-2500

Fax

(530) 226-1375

NPI assigned

Sep 13, 2005

Organization subpart

No

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

Authorized official

Name

Mr. George Neal

Title

Assistant Secretary

Phone

(844) 377-6468

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Larkspur Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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

• Bryan Glenn Crum, MD

  • Ophthalmology Physician
  • Redding, CA
  • NPI 1902891385
  Medicare reassignment Care Compare group NPD
• Robert C Fox, MD

  • Ophthalmology Physician
  • Redding, CA
  • NPI 1508869819
  Medicare reassignment Care Compare group NPD
• Michael Sota Jitosho, OD

  • Optometrist
  • Orange, CA
  • NPI 1740767201
  Medicare reassignment Care Compare group NPD
• Bruce Edward Silverstein, MD

  • Ophthalmology Physician
  • Redding, CA
  • NPI 1255326476
  Medicare reassignment Care Compare group NPD
• Harmohina Bagga, M.D.

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1306024104

  CA

  Medicare reassignment Care Compare group NPD
• Christopher Blake Myers, M.D.

  • Ophthalmology Physician
  • Redding, CA
  • NPI 1023088770
  Medicare reassignment NPD
• Catherine Bichha Pham, MD

  • Ophthalmology Physician
  • San Jose, CA
  • NPI 1760474159
  Medicare reassignment NPD
• Christopher Lin, MD, FACS

  • Ophthalmology Physician
  • Eureka, CA
  • NPI 1811982291
  Medicare reassignment

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1346235603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398986",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941395898",
            "telephone_number": "530-223-2500",
            "fax_number": "530-226-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 CHURN CREEK RD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022122",
            "telephone_number": "530-223-2500",
            "fax_number": "530-226-1375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2620 Larkspur Ln Ste L",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960021043",
            "country_code": "US",
            "telephone_number": "532-223-4300",
            "fax_number": "532-222-8903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Butte St",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960010827",
            "country_code": "US",
            "telephone_number": "530-223-2500",
            "fax_number": "530-221-4914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHASTA EYE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "844-377-6468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larkspur Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shasta County Young Men's Christian Association (Shasta Family YMCA)
• Shasta Critical Care Specialists Medical Clinic, Inc.
• Shasta Emergency Medical Associates Inc
• Shasta Emergency Medical Group
• Shasta ENT Specialists
• Shasta Eye Surgeons Inc (Surgery Center of Northern California)
• Shasta Hearing AIDS
• Shasta Heart Partners Inc
• Shasta Integrative Health
• Shasta Internal Medicine a Medical Corporation

• Ophthalmology Physician in Redding, CA
• Providers in Redding, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.