Individual provider Active NPI

Thomas Ralph Casagrande, OD

  • Optometrist
  • Fresno, CA
National Provider Identifier
1629108600
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7751T Issued in CA
Practice address
5110 N Blackstone Ave Ste 108
Fresno, CA 93710-6708
Phone
(559) 221-8900
Fax
(559) 221-1831
NPI assigned
Mar 7, 2007
Last updated
May 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7751T CA Primary

Addresses

Primary practice location

5110 N Blackstone Ave Ste 108
Fresno, CA 93710-6708

Mailing address

5110 N. Blackstone Ave Ste 108
Fresno, CA 93710-6708
Phone (559) 221-8900

Other identifiers 2

IdentifierTypeStateIssuer
810637142OtherCATAX ID
7751TOtherCALICENSE

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
I20040728000555 CA Practitioner - Optometry 1557331808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1983
Medicare assignment
May accept Medicare assignment
Group practices
20/20 Optometric Thomas Casagrande ODGroup PAC ID 0941270292, 2 clinicians

Practice addresses (Care Compare)

5110 N Blackstone Ave
Suite 108
Fresno, CA 93710-6708
Phone (559) 221-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7751TCAMDOptometrist
7751CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
20/20 Optometric Thomas Casagrande, OD Optometrist CurrentSince Nov 7, 2011 Accepting new patients

Locations

5110 N Blackstone Ave
Ste 108
Fresno, CA 93710
Phone (559) 221-8900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1629108600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 N. BLACKSTONE AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106708",
            "telephone_number": "559-221-8900",
            "fax_number": "559-221-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 N BLACKSTONE AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106708",
            "telephone_number": "559-221-8900",
            "fax_number": "559-221-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASAGRANDE",
        "first_name": "THOMAS",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7751T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "810637142",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7751T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.