NPIMap

Organization Active NPI

Eyecare Specialists Medical Group, Inc

Doing business as Atlantis Eyecare

  • Ophthalmology Physician
  • Indio, CA
National Provider Identifier
1750909065
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYECARE SPECIALISTS MEDICAL GROUP, INC
Doing business as
Atlantis Eyecare
Practice address
81893 Dr Carreon Blvd Ste 101
Indio, CA 92201-0604
Phone
(760) 396-3600
Fax
(760) 396-5379
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Authorized official

Name
Felisa Marisol Galindo
Title
Credentialing Supervisor
Phone
(626) 305-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

81893 Dr Carreon Blvd Ste 101
Indio, CA 92201-0604

Mailing address

1595 E 17TH St
Santa Ana, CA 92705-8506
Phone (714) 399-0678

Other names 1

  • Atlantis Eyecare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Spec Med GRP10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1750909065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058506",
            "telephone_number": "714-399-0678",
            "fax_number": "714-276-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81893 DR CARREON BLVD STE 101",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010604",
            "telephone_number": "760-396-3600",
            "fax_number": "760-396-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE SPECIALISTS MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "GALINDO",
        "authorized_official_first_name": "FELISA",
        "authorized_official_middle_name": "MARISOL",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "626-305-9100"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantis Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlantis Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.