Three Rivers Optometric Group Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

12712T Issued in CA

Legal business name

THREE RIVERS OPTOMETRIC GROUP INC

Practice address

1245 Tharp Rd
Yuba City, CA 95993

Phone

(530) 674-5273

Fax

(530) 674-5275

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Gary R Taxera, ODNPI 1326094392

Title

President

Phone

(530) 674-5273

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

Practitioners 5

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

• Gary Richard Taxera, OD

  • Optometrist
  • Yuba City, CA
  • NPI 1326094392
  Medicare reassignment Care Compare group NPD Authorized official
• Justin Marc Tolman, OD

  • Optometrist
  • Yuba City, CA
  • NPI 1396790689
  Medicare reassignment Care Compare group NPD
• Bradley R Baker, OD

  • Optometrist
  • Colusa, CA
  • NPI 1154376283
  NPD (past)
• David Q Le, O.D.

  • Optometrist
  • Galt, CA
  • NPI 1275510927
  NPD (past)
• Kathleen Lau Ngo, O.D.

  • Optometrist
  • Yuba City, CA
  • NPI 1962457978
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1497866545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 THARP RD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "95993",
            "telephone_number": "530-674-5273",
            "fax_number": "530-674-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 THARP RD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "95993",
            "telephone_number": "530-674-5273",
            "fax_number": "530-674-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS OPTOMETRIC GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "TAXERA",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-674-5273",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7072T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7125T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12712T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR949",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004280",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE",
            "identifier": "CK6935",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "ZZZ078052",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CIGNA",
            "identifier": "4598980001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.