Individual provider Active NPI

Bruce Howarth Carr, O.D.

  • Optometrist
  • Vacaville, CA
National Provider Identifier
1457365678
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10293T Issued in CA
Practice address
513 Merchant St
Vacaville, CA 95688-4511
Phone
(707) 448-3451
Fax
(707) 448-1304
NPI assigned
Jul 27, 2006
Last updated
Jul 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10293T CA Primary

Addresses

Primary practice location

513 Merchant St
Vacaville, CA 95688-4511

Mailing address

513 Merchant St
Vacaville, CA 95688-4511
Phone (707) 448-3451

Other identifiers 1

IdentifierTypeStateIssuer
SD0102930MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080723000920 CA Practitioner - Optometry 8729151782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

513 Merchant St
Vacaville, CA 95688-4511
Phone (707) 448-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10293TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group PastSince Jan 1, 1994 Accepting new patients

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1457365678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 MERCHANT ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884511",
            "telephone_number": "707-448-3451",
            "fax_number": "707-448-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 MERCHANT ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884511",
            "telephone_number": "707-448-3451",
            "fax_number": "707-448-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "BRUCE",
        "middle_name": "HOWARTH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10293T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0102930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.