NPIMap

Organization Active NPI

Orange County Ophthalmology Medical Group

Doing business as Orange County Eye Surgical Center

  • Ophthalmology Physician
  • Garden Grove, CA
National Provider Identifier
1740362631
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ORANGE COUNTY OPHTHALMOLOGY MEDICAL GROUP
Doing business as
Orange County Eye Surgical Center
Practice address
12665 Garden Grove Blvd
#401
Garden Grove, CA 92843
Phone
(714) 534-8373
Fax
(714) 534-8759
NPI assigned
Oct 19, 2006
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Mrs. Ruth Gasso
Title
Office Administrator
Phone
(714) 534-8353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

12665 Garden Grove Blvd
#401
Garden Grove, CA 92843

Mailing address

12665 Garden Grove Blvd
#401
Garden Grove, CA 92843
Phone (714) 534-8373

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ74712ZMedicaidCA

Other names 1

  • Orange County Eye Surgical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913001422 CA Part B Supplier - Clinic/Group Practice 8921075599 Receives reassigned benefits from 7 practitioners
Practice locations: Garden Grove, 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
Tax ID family
Orange County Eye Surgical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12665 Garden Grove Blvd
Ste 401
Garden Grove, CA 92843
Phone (714) 534-8373

Practitioners & affiliated clinicians

Practitioners 10

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": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1740362631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "#401",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-534-8373",
            "fax_number": "714-534-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "#401",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "92843",
            "telephone_number": "714-534-8373",
            "fax_number": "714-534-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COUNTY OPHTHALMOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "GASSO",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "714-534-8353",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ74712Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange County Eye Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.