Tracy Optometry Group, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

COR1056 Issued in CA

Legal business name

TRACY OPTOMETRY GROUP, INC

Practice address

36 W 10TH St
Tracy, CA 95376-3902

Phone

(209) 835-7446

Fax

(209) 835-3572

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David C Moline, 0.D.NPI 1134133929

Title

President

Phone

(209) 835-7446

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Charles Moline, OD

  • Optometrist
  • Tracy, CA
  • NPI 1134133929
  Medicare reassignment Care Compare group NPD Authorized official
• Timothy NG, O.D.

  • Optometrist
  • Stockton, CA
  • NPI 1063825156
  Medicare reassignment Care Compare group NPD
• Neelam Thiara, DOCTOR OF OPTOMETRY

  • Optometrist
  • Tracy, CA
  • NPI 1477108421
  Medicare reassignment Care Compare group NPD
• Brian Michael Yee, O.D.

  • Optometrist
  • Tracy, CA
  • NPI 1497733729
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1740409648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W 10TH ST",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763902",
            "telephone_number": "209-835-7446",
            "fax_number": "209-835-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W 10TH ST",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763902",
            "telephone_number": "209-835-7446",
            "fax_number": "209-835-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY OPTOMETRY GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "MOLINE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-835-7446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "0.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD005210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Dermatology Medical Group
• Tracy Eye Care Medical Clinic
• Tracy Family Dental Center
• Tracy Hills Dental Care
• Tracy Learning Center
• Tracy Orchard Dental Care
• Tracy Orthopedics and Sports Medical Center
• Tracy Outpatient Surgery Center
• Tracy Surgery Center, LLC
• Tracy Unified School District

• Optometrist in Tracy, CA
• Providers in Tracy, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.