NPIMap

Organization Active NPI

North Lake Eyecare Optometry

  • Optometrist
  • Tahoe City, CA
National Provider Identifier
1447580360
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9655T Issued in CA
Legal business name
NORTH LAKE EYECARE OPTOMETRY
Practice address
1225 N Lake Blvd
Tahoe City, CA 96145-7170
Phone
(530) 583-5004
Fax
(530) 583-0217
NPI assigned
Dec 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Authorized official

Name
Dr. Margaret D Raulino, O.D.
Title
Optometrist/Owner
Phone
(530) 583-5004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 9655T CA Primary

Addresses

Primary practice location

1225 N Lake Blvd
Tahoe City, CA 96145-7170

Mailing address

PO Box 7170
Tahoe City, CA 96145-7170
Phone (530) 583-5004

Other identifiers 1

IdentifierTypeStateIssuer
GSD001010MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1447580360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7170",
            "city": "TAHOE CITY",
            "state": "CA",
            "postal_code": "961457170",
            "telephone_number": "530-583-5004",
            "fax_number": "530-583-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N LAKE BLVD",
            "city": "TAHOE CITY",
            "state": "CA",
            "postal_code": "961457170",
            "telephone_number": "530-583-5004",
            "fax_number": "530-583-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE EYECARE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "RAULINO",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "530-583-5004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9655T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD001010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahoe City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.