Active NPI
Thomas A Aller, O.D.
- Optometrist
- San Bruno, CA
National Provider Identifier
1366431330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7684T
- Practice address
- 648 Jenevein Ave
San Bruno, CA 94066-4230 - Phone
- (650) 871-1816
- Fax
- (650) 871-0164
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 7684T | CA | |
| Optometrist | 152W00000X | 7684T | CA | Primary |
Addresses
Primary practice location
648 Jenevein Ave
San Bruno, CA 94066-4230
Mailing address
648 Jenevein Ave
San Bruno, CA 94066-4230
Phone (650) 871-1816
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060209000188 | CA | Practitioner - Optometry | 6002821287 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7684T | CA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fourth Optometric Care of California | Optometrist | Current | Accepting new patients |
| Lillie Mosaddegh MD Inc | Current | Accepting new patients | |
| Fourth Optometric Care of California | Optometrist | Current | Accepting new patients |
| Fourth Optometric Care of California | Optometrist | Current | Accepting new patients |
Locations
3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564
648 Jenevein Ave
San Bruno, CA 94066
Phone (650) 583-9888
380 West Portal Ave
Ste B
San Francisco, CA 94127
Phone (415) 392-4437
Interoperability endpoints
- taller@sfeyedoctors.intellechartdirect.net
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.
-
- Optometrist
- Mountain View, CA
- NPI 1689248874
-
- Optometrist
- San Bruno, CA
- NPI 1750052189
-
- Ophthalmology Physician
- San Francisco, CA
- NPI 1326248923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748131200000",
"number": "1366431330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "648 JENEVEIN AVE",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940664230",
"telephone_number": "650-871-1816",
"fax_number": "650-871-0164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "648 JENEVEIN AVE",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940664230",
"telephone_number": "650-871-1816",
"fax_number": "650-871-0164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLER",
"first_name": "THOMAS",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2025-05-25",
"certification_date": "2025-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "7684T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7684T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2025; 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.