Organization Active NPI

Peninsula Ophthalmology Group, Inc.

  • Ophthalmology Physician
  • Burlingame, CA
National Provider Identifier
1447303995
Registry record updated Dec 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PENINSULA OPHTHALMOLOGY GROUP, INC.
Practice address
1720 El Camino Real Ste 225
Burlingame, CA 94010-3230
Phone
(650) 697-3200
Fax
(650) 697-3203
NPI assigned
Jan 19, 2007
Last updated
Dec 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2015

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

Authorized official

Name
Brenda Almes
Title
Administrator
Phone
(650) 697-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1720 El Camino Real Ste 225
Burlingame, CA 94010-3230

Mailing address

1720 El Camino Real Ste 225
Burlingame, CA 94010-3230
Phone (650) 697-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803000863 CA Part B Supplier - Clinic/Group Practice 0042281164 Receives reassigned benefits from 18 practitioners
Practice locations: Daly City, CA; San Francisco, CA; Burlingame, CA

National Provider Directory

National Provider Directory

Locations

901 Campus Dr
Ste 205
Daly City, CA 94015
Phone (650) 343-9746

1001 Sneath Ln
Ste 206
San Bruno, CA 94066
Phone (415) 871-8856

292 Geary St Ste 700
San Francisco, CA 94102

100 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 696-4140

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451088000000",
    "number": "1447303995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL STE 225",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103230",
            "telephone_number": "650-697-3200",
            "fax_number": "650-697-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL STE 225",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103230",
            "telephone_number": "650-697-3200",
            "fax_number": "650-697-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA OPHTHALMOLOGY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-12-26",
        "status": "A",
        "authorized_official_last_name": "ALMES",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "650-697-3200"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.