Individual provider Active NPI

Robert Melrose, O.D.

  • Optometrist
  • Stockton, CA
National Provider Identifier
1659485175
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7526T Issued in CA
Practice address
3133 W March LN
Ste. 2020
Stockton, CA 95219-2336
Phone
(209) 951-0820
Fax
(209) 951-2348
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7526T CA Primary

Addresses

Primary practice location

3133 W March LN
Ste. 2020
Stockton, CA 95219-2336

Mailing address

3133 W March LN
Ste. 2020
Stockton, CA 95219-2336

Other identifiers 2

IdentifierTypeStateIssuer
0694800001OtherCADMERC
SD0075260MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75260CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
First Optometric Care of Northern California PC Optometrist Current Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
Griffin & Reed a Medical Corporation Optometrist PastSince Jan 5, 2004 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

100 S Harding Blvd
Roseville, CA 95678
Phone (916) 783-8109

3133 W March Ln
Ste 2020
Stockton, CA 95219
Phone (209) 951-0820

Organizations & group practices 5

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1659485175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN",
            "address_2": "STE. 2020",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN",
            "address_2": "STE. 2020",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192336",
            "telephone_number": "209-951-0820",
            "fax_number": "209-951-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELROSE",
        "first_name": "ROBERT",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7526T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0694800001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0075260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.