Individual provider Active NPI

John J Eliopulos, O.D.

  • Optometrist
  • Elk Grove, CA
National Provider Identifier
1619930500
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6207 Issued in CA
Practice address
9074 Elk Grove Blvd
Elk Grove, CA 95624-2046
Phone
(916) 685-6100
Fax
(916) 685-0279
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6207 CA Primary

Addresses

Primary practice location

9074 Elk Grove Blvd
Elk Grove, CA 95624-2046

Mailing address

9074 Elk Grove Blvd
Elk Grove, CA 95624-2046
Phone (916) 685-6100

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
I20080505000777 CA Practitioner - Optometry 3274612064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
John J Eliopulos O.D. Inc Optometrist CurrentSince Mar 20, 1981 Accepting new patients

Locations

9074 Elk Grove Blvd
Elk Grove, CA 95624
Phone (916) 685-6100

9074 Elk Grove Blvd
Ste 4
Elk Grove, CA 95624
Phone (916) 685-6100

Organizations & group practices 1

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619930500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9074 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242046",
            "telephone_number": "916-685-6100",
            "fax_number": "916-685-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9074 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242046",
            "telephone_number": "916-685-6100",
            "fax_number": "916-685-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIOPULOS",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.