Individual provider Active NPI

Brian D Tracy, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1356308266
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9109T Issued in CA
Practice address
3000 L St
Suite 100
Sacramento, CA 95816-5248
Phone
(916) 454-5729
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9109T CA Primary

Addresses

Primary practice location

3000 L St
Suite 100
Sacramento, CA 95816-5248

Mailing address

3000 L St
Suite 100
Sacramento, CA 95816-5248
Phone (916) 454-5729

Other identifiers 7

IdentifierTypeStateIssuer
46598OtherCASAFEGUARD VISION
211188OtherCAEYEMED
00E630000OtherCADMERC SIGNA
02338OtherCAMEDICAL EYE SERVICES
SD0091090MedicaidCA
410012517OtherCARAILROAD MEDICARE
34392OtherCADAVIS VISION

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
I20080731000752 CA Practitioner - Optometry 4688610272 Reassigns benefits to 1 organization
Practice locations: Roseville, CA; Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 Alhambra Blvd
Suite 202
Sacramento, CA 95816-7050
Phone (916) 731-8040

Merit-based Incentive Payment System (MIPS)

Final score
87.7 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
78.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
9109TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Vision Technology Ophthalmology Medical Group Inc. CurrentSince Sep 1, 2018 Accepting new patients
Medical Vision Technology Ophthalmology Medical Group Inc. Current Accepting new patients
Brian D Tracy OD Optometrist PastSince Jan 1, 1990 Accepting new patients
Brian D Tracy, OD Optometrist PastSince Jan 1, 1990 Accepting new patients

Locations

1830 Sierra Gardens Dr
Ste 100
Roseville, CA 95661
Phone (916) 782-2111

1700 Alhambra Blvd
Ste 202
Sacramento, CA 95816
Phone (916) 453-2921

Organizations & group practices 4

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1356308266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 L ST",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165248",
            "telephone_number": "916-454-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 L ST",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165248",
            "telephone_number": "916-454-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "BRIAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9109T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD VISION",
            "identifier": "46598",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "211188",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC SIGNA",
            "identifier": "00E630000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "02338",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0091090",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410012517",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "34392",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.