Individual provider Active NPI

Rosemary Melrose, O.D.

  • Optometrist
  • Stockton, CA
National Provider Identifier
1366556870
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7561T Issued in CA
Practice address
3133 W March LN
Ste. 2020
Stockton, CA 95219-2361
Phone
(209) 951-0820
Fax
(209) 951-2348
NPI assigned
Aug 19, 2006
Last updated
Mar 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7561T CA Primary

Addresses

Primary practice location

3133 W March LN
Ste. 2020
Stockton, CA 95219-2361

Mailing address

3133 W March LN Ste 2020
Stockton, CA 95219-2361
Phone (209) 951-0820

Other identifiers 2

IdentifierTypeStateIssuer
0694800001OtherCADMERC
SD0075610MedicaidCA

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7561TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
First Optometric Care of Northern California PC Optometrist Current Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
Valley Optometric Care Optometrist Current Accepting new patients
Brookside Optometric Group Optometrist CurrentSince Apr 1, 2018 Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
Fourth Optometric Care of California Optometrist PastSince Apr 19, 2022 Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

100 S Harding Blvd
Roseville, CA 95678
Phone (916) 783-8109

3133 W March Ln
Ste 2020
Stockton, CA 95219
Phone (209) 951-0820

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1366556870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN STE 2020",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192361",
            "telephone_number": "209-951-0820",
            "fax_number": "209-951-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN",
            "address_2": "STE. 2020",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192361",
            "telephone_number": "209-951-0820",
            "fax_number": "209-951-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELROSE",
        "first_name": "ROSEMARY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7561T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0694800001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0075610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.