Individual provider Active NPI

Timothy James Doran, OD

  • Optometrist
  • Riverside, CA
National Provider Identifier
1538144076
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT8455T Issued in CA
Practice address
6405 Day St
Riverside, CA 92507-0901
Phone
(951) 697-5480
Fax
(951) 697-5486
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT8455T CA Primary

Addresses

Primary practice location

6405 Day St
Riverside, CA 92507-0901

Mailing address

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5480

Other identifiers 1

IdentifierTypeStateIssuer
ZZZZ92058ZOtherGRP SITE LOCATION

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
I20070612000762 CA Practitioner - Optometry 1557469764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5556

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT8455TCAMDOptometrist
8455CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Current Accepting new patients
Riverside Medical Clinic, Inc Optometrist CurrentSince Nov 27, 2006 Accepting new patients

Locations

6405 Day St
Riverside, CA 92507
Phone (909) 683-6370

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1538144076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5480",
            "fax_number": "951-697-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5480",
            "fax_number": "951-697-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8455T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP SITE LOCATION",
            "identifier": "ZZZZ92058Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.