Active NPI
Jason Matthew Thai, OD
- Optometrist
- Roseville, CA
National Provider Identifier
1366333064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT36004-TLG
- Practice address
- 1011 Riverside Ave FL 2
Roseville, CA 95678-5134 - Phone
- (916) 784-4185
- NPI assigned
- Jul 10, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT36004-TLG | CA | Primary |
Addresses
Primary practice location
1011 Riverside Ave FL 2
Roseville, CA 95678-5134
Mailing address
1515 N Vermont Ave FL 6
Los Angeles, CA 90027-5337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT36004-TLG | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1366333064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 N VERMONT AVE FL 6",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900275337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 RIVERSIDE AVE FL 2",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956785134",
"telephone_number": "916-784-4185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAI",
"first_name": "JASON",
"middle_name": "MATTHEW",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-10",
"last_updated": "2026-09-07",
"certification_date": "2026-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT36004-TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
- Marisa Angelina Terrazas, BOC
- Erin Kathleen Tessendorff, PHARMD, RPH
- Kristen Annette Tetrick, R.N.
- Gary J. Thacker, MD
- Vishruth Thaghalli Sunilkumar, MD
- Kimberly Thai, DO
- Jay Harshadbhai Thakkar, MD
- Thalia Nicholson Psychological Services, Inc.
- Joshua Thomas Thatch
- The Davis Group Counseling and Wellness Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.