NPIMap

Organization Active NPI

Sierra Eye Medical Group Inc.

  • Ophthalmology Physician
  • Visalia, CA
National Provider Identifier
1649214388
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SIERRA EYE MEDICAL GROUP INC.
Practice address
2830 W Main St
Visalia, CA 93291-4331
Phone
(559) 636-1000
Fax
(559) 733-7438
NPI assigned
Jun 15, 2006
Last updated
Oct 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Mrs. Pat H Marquez
Title
Director Business Services
Phone
(559) 636-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

2830 W Main St
Visalia, CA 93291-4331

Mailing address

2830 W Main St
Visalia, CA 93291-4331
Phone (559) 636-1000

Other identifiers 2

IdentifierTypeStateIssuer
A133113OtherCACALIFORNIA PHYSICIAN AND SURGEON
GR0048030MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dstark@sierraeye.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040618001350 CA Part B Supplier - Clinic/Group Practice 2769467380 Receives reassigned benefits from 6 practitioners
Practice locations: Visalia, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: dstark@sierraeye.com
  • Direct secure messaging: lbaloian@sierraeyemed.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1649214388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 W MAIN ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914331",
            "telephone_number": "559-636-1000",
            "fax_number": "559-733-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 W MAIN ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914331",
            "telephone_number": "559-636-1000",
            "fax_number": "559-733-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA EYE MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "PAT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR BUSINESS SERVICES",
        "authorized_official_telephone_number": "559-636-1000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA PHYSICIAN AND SURGEON",
            "identifier": "A133113",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0048030",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dstark@sierraeye.com",
            "affiliation": "N",
            "endpointDescription": "Sierra Eye Medical Group HIPAA compliant e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2830 W Main St",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932914331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.