NPIMap

Organization Active NPI

Third Optometric Care of California PC

  • Optometrist
  • Elk Grove, CA
National Provider Identifier
1770161655
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
THIRD OPTOMETRIC CARE OF CALIFORNIA PC
Practice address
5050 Laguna Blvd Ste 113
Elk Grove, CA 95758-4151
Phone
(916) 684-7070
NPI assigned
Mar 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Brittany Harrison
Title
Director
Phone
(916) 851-6323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5050 Laguna Blvd Ste 113
Elk Grove, CA 95758-4151

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (916) 407-7156

Other names 1

  • Laguna Creek Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210427002381 CA Part B Supplier - Clinic/Group Practice 8325456536 Receives reassigned benefits from 28 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Auburn, CA; Buena Park, CA; Elk Grove, CA; Irvine, CA; Ojai, CA; Palmdale, CA; Rancho Cordova, CA; Rialto, CA…

National Provider Directory

National Provider Directory
Tax ID family
Antelope Mall Vision Center Optometry11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1211 Maricopa Hwy
Ste 101
Ojai, CA 93023
Phone (805) 646-5109

Ownership & related parties

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1770161655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985",
            "telephone_number": "916-407-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 LAGUNA BLVD STE 113",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584151",
            "telephone_number": "916-684-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD OPTOMETRIC CARE OF CALIFORNIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "916-851-6323"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Creek Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Laguna Creek Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.