Active NPI
Camille M. Harrison, MD
- Ophthalmology Physician
- Rancho Mirage, CA
National Provider Identifier
1366520140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A64900
- Practice address
- 72301 Country Club Dr
Suite 108
Rancho Mirage, CA 92270-8007 - Phone
- (760) 895-1993
- Fax
- (760) 862-1992
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A64900 | CA | Primary |
Addresses
Primary practice location
72301 Country Club Dr
Suite 108
Rancho Mirage, CA 92270-8007
Mailing address
72301 Country Club Dr
Suite 108
Rancho Mirage, CA 92270-8007
Phone (760) 895-1993
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A649000 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Baylor College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
72301 Country Club Dr
Suite 108
Rancho Mirage, CA 92270-8007
Phone (760) 895-1993
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64900 | CA | MD | General Practice Dentistry |
| A64900 | CA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coachella Valley Retina | Ophthalmology | Current | Accepting new patients |
| Lauren R Rosecan Mdpa | Past | Accepting new patients | |
| Eisenhower Medical Center | Past | Accepting new patients | |
| Coachella Valley Retina | Ophthalmology | Past | Accepting new patients |
| Diagnostic Imaging Services | Past | Accepting new patients |
Locations
72301 Country Club Dr
Ste 108
Rancho Mirage, CA 92270
Phone (760) 346-0553
Organizations & group practices 5
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.
-
- Ophthalmology Physician
- Rancho Mirage, CA
- NPI 1376970228
-
- Ophthalmology Physician
- Rancho Mirage, CA
- NPI 1871928945
-
- General Acute Care Hospital
- Rancho Mirage, CA
- NPI 1013981554
-
- Magnetic Resonance Imaging (MRI) Internal Medicine Physician
- Metairie, LA
- NPI 1699793166
-
- Specialist
- Palm Beach Gardens, FL
- NPI 1134314933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381795200000",
"number": "1366520140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72301 COUNTRY CLUB DR",
"address_2": "SUITE 108",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922708007",
"telephone_number": "760-895-1993",
"fax_number": "760-862-1992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72301 COUNTRY CLUB DR",
"address_2": "SUITE 108",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922708007",
"telephone_number": "760-895-1993",
"fax_number": "760-862-1992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "CAMILLE",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2013-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A64900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A649000",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; 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.
- 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.