Livia Speare Galli Rasmussen, OD, MS
Individual provider Active NPI Optometrist · Sonora, CA
NPI 1417618117 · NPPES record last updated Mar 12, 2024
Key facts
- NPI
- 1417618117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 35195TLG (CA)
- Practice address
- 940 Sylva LN Ste H
Sonora, CA 95370-5969 - Phone
- (209) 532-4123
- Fax
- (209) 532-6749
- NPI assigned
- Jan 5, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
- Group practices
- M a C T Health Board Incorporated
Practice addresses (Care Compare)
940 Sylva LN
Suite H
Sonora, CA 95370-5969
Phone (209) 288-6530
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230907004022 | CA | Practitioner - Optometry | 9931563061 | |
| I20241126001959 | TX | Practitioner - Optometry | 9931563061 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35195TLG | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zeiter Eye Medical Group, Inc. | Past | Accepting new patients | |
| M a C T Health Board Incorporated | Past | Accepting new patients | |
| M a C T Health Board, Incorporated | Optometrist | Past | Accepting new patients |
| Chris Iwata, OD | Optometrist | Past | Accepting new patients |
Interoperability endpoints
- livia.gallirasmussen.p1@direct.macthealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 35195TLG | CA | Yes |
Addresses
Primary practice location
940 Sylva LN Ste H
Sonora, CA 95370-5969
Mailing address
PO Box 1184
San Andreas, CA 95249-1184
Other practice location 1
4440 Calaveritas Rd
San Andreas, CA 95249-9756
Phone (209) 981-8098
Other practice location 2
595 Stanislaus Ave
Angels Camp, CA 95222-9356
Phone (209) 736-0908
Other names
- Ms. Livia Catherine Speare Galli
Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.