NPIMap

Organization Active NPI

Foresight Eyecare Optometry

  • Optometrist
  • Concord, CA
National Provider Identifier
1770937484
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13574TLG Issued in CA
Legal business name
FORESIGHT EYECARE OPTOMETRY
Practice address
5442 Ygnacio Valley Rd
Suite 180
Concord, CA 94521-3800
Phone
(925) 672-4100
Fax
(925) 672-4195
NPI assigned
Apr 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Authorized official

Name
Dr. Richard J Michelsen, ODNPI 1417104670
Title
President
Phone
(925) 672-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 13574TLG CA Primary

Addresses

Primary practice location

5442 Ygnacio Valley Rd
Suite 180
Concord, CA 94521-3800

Mailing address

5442 Ygnacio Valley Rd
Suite 180
Concord, CA 94521-3800
Phone (925) 672-4100

Other names 1

  • Foresight Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161104002033 CA Part B Supplier - Clinic/Group Practice 5092093435 Receives reassigned benefits from 5 practitioners
Practice locations: Concord, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1461024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1770937484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5442 YGNACIO VALLEY RD",
            "address_2": "SUITE 180",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945213800",
            "telephone_number": "925-672-4100",
            "fax_number": "925-672-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5442 YGNACIO VALLEY RD",
            "address_2": "SUITE 180",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945213800",
            "telephone_number": "925-672-4100",
            "fax_number": "925-672-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORESIGHT EYECARE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "MICHELSEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-672-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13574TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foresight Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.