Individual provider Active NPI

Rita Shah Narain-Mendoza, OD

  • Optometrist
  • Vallejo, CA
National Provider Identifier
1720198971
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13113 Issued in CA
Practice address
2623 Springs Rd
Vallejo, CA 94591-5712
Phone
(707) 643-8202
Fax
(707) 643-8227
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13113 CA Primary

Addresses

Primary practice location

2623 Springs Rd
Vallejo, CA 94591-5712

Mailing address

2623 Springs Rd
Vallejo, CA 94591-5712
Phone (510) 484-5014

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
I20060920000415 CA Practitioner - Optometry 2264437508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2623 Springs Rd
Vallejo, CA 94591-5712
Phone (707) 643-8202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13113CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rita Narain-Mendoza, O.D., Inc. Optometrist CurrentSince Jul 19, 2010 Accepting new patients
Family Eye Associates Optometric Group, Inc. Optometrist Past Accepting new patients
Family Eye Associates Optometrist Past Accepting new patients

Locations

2623 Springs Rd
Vallejo, CA 94591
Phone (707) 643-8202

Organizations & group practices 3

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1720198971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 SPRINGS RD",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915712",
            "telephone_number": "510-484-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 SPRINGS RD",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915712",
            "telephone_number": "707-643-8202",
            "fax_number": "707-643-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARAIN-MENDOZA",
        "first_name": "RITA",
        "middle_name": "SHAH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.