Individual provider Active NPI

Darwin C Tsang, O.D.

  • Optometrist
  • Petaluma, CA
National Provider Identifier
1619344918
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15225 TLG Issued in CA
Practice address
401 Kenilworth Dr
Inside Target Optical
Petaluma, CA 94952-3400
Phone
(707) 775-6022
Fax
(707) 782-0568
NPI assigned
Aug 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 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 15225 TLG CA Primary

Addresses

Primary practice location

401 Kenilworth Dr
Inside Target Optical
Petaluma, CA 94952-3400

Mailing address

707 Kenilworth Drive
Inside Target Optical
Petaluma, CA 94952-3400
Phone (707) 782-0572

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
I20151229002601 CA Practitioner - Optometry 9931401429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marin Optometric Group IncGroup PAC ID 1850644733, 2 clinicians

Practice addresses (Care Compare)

1001 Grand Ave
San Rafael, CA 94901-3416
Phone (415) 453-3812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15225 TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Optometric Group, Inc Optometrist CurrentSince Oct 1, 2018 Accepting new patients
Robert B Levine OD a Professional Optometric Corporation Optometrist CurrentSince Oct 1, 2018 Accepting new patients

Locations

1001 Grand Ave
San Rafael, CA 94901
Phone (415) 453-3812

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": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1619344918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 KENILWORTH DRIVE",
            "address_2": "INSIDE TARGET OPTICAL",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523400",
            "telephone_number": "707-782-0572",
            "fax_number": "707-782-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KENILWORTH DR",
            "address_2": "INSIDE TARGET OPTICAL",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523400",
            "telephone_number": "707-775-6022",
            "fax_number": "707-782-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSANG",
        "first_name": "DARWIN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-21",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15225 TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.