Organization Active NPI

Avani Patel Optometric Corporation

  • Optometrist
  • Fresno, CA
National Provider Identifier
1659096220
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AVANI PATEL OPTOMETRIC CORPORATION
Practice address
4983 N Blackstone Ave
Fresno, CA 93726-0109
Phone
(510) 731-7873
NPI assigned
Oct 6, 2022
Last updated
Oct 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Authorized official

Name
Avani Patel, ODNPI 1871825570
Title
Owner
Phone
(510) 457-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4983 N Blackstone Ave
Fresno, CA 93726-0109

Mailing address

4983 N Blackstone Ave
Fresno, CA 93726-0109

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221205001258 CA Part B Supplier - Clinic/Group Practice 1052780632 Receives reassigned benefits from 22 practitioners
Practice locations: Visalia, CA; Fresno, CA; Salinas, CA; Sacramento, CA; Roseville, CA; Monterey, CA; Redding, CA; Fair Oaks, CA…

National Provider Directory

National Provider Directory

Locations

5345 Sunrise Blvd
Ste B
Fair Oaks, CA 95628
Phone (510) 731-7873

7825 N Blackstone Ave
Fresno, CA 93720
Phone (510) 457-6300

228 Del Monte Ctr
Monterey, CA 93940
Phone (831) 375-3771

1151 Galleria Blvd
Ste 175
Roseville, CA 95678
Phone (916) 788-2960

8128 Delta Shores Cir S
Sacramento, CA 95832
Phone (510) 457-6300

670 Northridge Mall
Ste F8
Salinas, CA 93906
Phone (510) 731-7873

2223 S Mooney Blvd
Ste 820
Visalia, CA 93277
Phone (510) 731-7873

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1659096220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4983 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4983 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260109",
            "telephone_number": "510-731-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANI PATEL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AVANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-457-6300",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.