Ronald Lee Harris, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

04916TPG Issued in CA

Practice address

1225 North McDowell Blvd.
Petaluma, CA 94954-1112

Phone

(707) 763-2020

Fax

(707) 763-4735

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Petaluma Eye Care Optometric Associates, Inc. a Professional Corp.

  • Optometrist
  • Petaluma, CA
  • NPI 1851522411
  NPD (past) Authorized official

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1437159803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 NORTH MCDOWELL BLVD.",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541112",
            "telephone_number": "707-763-2020",
            "fax_number": "707-763-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 NORTH MCDOWELL BLVD.",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541112",
            "telephone_number": "707-763-2020",
            "fax_number": "707-763-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "RONALD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "04916TPG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0049160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annabel Lee Fischer Harper
• Kara Harris, RDN, CSG
• Kimberly Harris, MA
• Lindsey Harris, OTR
• Rachel Elizabeth Harris
• Sheryl Harris
• Austin Tehuiarii Hartford, DMD
• Carol A Harvey, MS
• Sohaib Hassan
• Lura Hawkins, LMFT # 105665

• Optometrist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.

Verify at the official NPI Registry.