Delta Eye Medical Group, Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

DELTA EYE MEDICAL GROUP, INC.

Practice address

521 S Ham LN
Suite a
Lodi, CA 95242-3528

Phone

(209) 334-5886

Fax

(209) 334-5281

NPI assigned

Oct 9, 2007

Organization subpart

Yes

Parent organization

DELTA EYE MEDICAL GROUP, INC.As reported in NPPES

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

Authorized official

Name

Ms. Laurie K Smith

Title

Corporate Controller

Phone

(209) 334-5886

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Tracy, CA
  • NPI 1184812851

  6204873870

  Same PAC ID
• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1407964679

  6204873870

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Tracy, CA
  • NPI 1184812851

  O20050414000825

  Same enrollment
• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1407964679

  O20050414000825

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Delta Eye Medical GRP3 organizations share this tax ID, including this one

Part of

Delta Eye Medical GRP

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Tracy, CA
  • NPI 1184812851
  NPD tax ID
• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1407964679
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Delta Eye Medical Group, Inc.

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1407964679
  NPPES parent name

Practitioners 4

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

• Andrew Philip Chen, M.D.

  • Ophthalmology Physician
  • Lodi, CA
  • NPI 1912014739
  NPD
• Aamun Garcha, OD

  • Optometrist
  • Stockton, CA
  • NPI 1639832801
  NPD
• Hieu Minh Ly, O.D.

  • Optometrist
  • Lodi, CA
  • NPI 1831445352
  NPD
• Julio Narvaez, M.D.

  • Ophthalmology Physician
  • Loma Linda, CA
  • NPI 1962427088
  NPD

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1457549123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S HAM LN",
            "address_2": "SUITE A",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423528",
            "telephone_number": "209-334-5886",
            "fax_number": "209-334-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S HAM LN",
            "address_2": "SUITE A",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423528",
            "telephone_number": "209-334-5886",
            "fax_number": "209-334-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA EYE MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELTA EYE MEDICAL GROUP, INC.",
        "enumeration_date": "2007-10-09",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CORPORATE CONTROLLER",
        "authorized_official_telephone_number": "209-334-5886",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD8211",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0008460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.