Russell Norman Cotteral, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9134 Issued in CA

Practice address

940 Sylva LN Ste H
Sonora, CA 95370-5969

Phone

(209) 532-4132

Fax

(209) 532-6749

NPI assigned

Jun 15, 2006

Last updated

Mar 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Optometry

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: russell.cotteral.p1@direct.macthealth.nextgenshare.com

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.

• M a C T Health Board Incorporated

  • Federally Qualified Health Center (FQHC)
  • San Andreas, CA
  • NPI 1366519431

  TX

  Medicare reassignment
• Kensington Optometry Inc

  • Optometrist
  • Kensington, CA
  • NPI 1801825591
  Authorized official Same address or phone
• M a C T Health Board Incorporated

  dba MACT Medical Sonora

  • Federally Qualified Health Center (FQHC)
  • Sonora, CA
  • NPI 1467444364
  NPD (past)
• M a C T Health Board, Incorporated

  dba MACT Health & Wellness, Sutter Creek

  • Federally Qualified Health Center (FQHC)
  • Sutter Creek, CA
  • NPI 1417741869

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1619911047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 COLUSA AVE",
            "city": "KENSINGTON",
            "state": "CA",
            "postal_code": "947071209",
            "telephone_number": "510-527-1714",
            "fax_number": "510-527-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 SYLVA LN STE H",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705969",
            "telephone_number": "209-532-4132",
            "fax_number": "209-532-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTERAL",
        "first_name": "RUSSELL",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "12452",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Leonard Comazzi, M.D.
• Continuum Family Health Medical Corporation
• Gina L Cook
• Zachary Adam Cooper, M.D.
• Suzanne Corgiat, MA IN PSYCHOLOGY
• County of Tuolumne (Tuolumne County Sheriff's Office)
• County of Tuolumne (Tuolumne General Hospital)
• County of Tuolumne (Tuolumne General Hospital)
• County of Tuolumne (Tuolumne County Ambulance)
• County of Tuolumne (Tuolumne General Hospital)

• Optometrist in Sonora, CA
• Providers in Sonora, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.