NPIMap

Organization Active NPI

East Bay Eye Centers Medical Corporation

  • Specialist
  • San Ramon, CA
National Provider Identifier
1780633644
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EAST BAY EYE CENTERS MEDICAL CORPORATION
Practice address
5801 Norris Canyon Road
Suite 200
San Ramon, CA 94583-5406
Phone
(925) 830-8823
Fax
(925) 866-6610
NPI assigned
May 9, 2006
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Mr. Tammy Carson
Title
Practice Administrator
Phone
(925) 830-2112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X CA Primary

Addresses

Primary practice location

5801 Norris Canyon Road
Suite 200
San Ramon, CA 94583-5406

Mailing address

5801 Norris Canyon Rd Ste 200
San Ramon, CA 94583-5440
Phone (925) 830-8823

Other practice location 1

8440 Brentwood Blvd Ste D
Brentwood, CA 94513-1300
Phone (925) 701-8824

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ05706ZOtherCABLUE SHIELD
ZZZ057067OtherCABLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050719000770 CA Part B Supplier - Clinic/Group Practice 1951290709 Receives reassigned benefits from 9 practitioners
Practice locations: Brentwood, CA; San Ramon, CA

National Provider Directory

National Provider Directory
Tax ID family
East Bay Eye Centers Medical2 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.

Interoperability endpoints

  • Direct secure messaging: aedell@ebec.intellechartdirect.net
  • Direct secure messaging: elaubach@ebec.intellechartdirect.net
  • Direct secure messaging: nakhondan@ebec.intellechartdirect.net
  • Direct secure messaging: osmith@ebec.intellechartdirect.net
  • Direct secure messaging: rraghu@ebec.intellechartdirect.net
  • Direct secure messaging: sseverin@ebec.intellechartdirect.net
  • Direct secure messaging: tseverin@ebec.intellechartdirect.net
  • Direct secure messaging: vfeiz@ebec.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1780633644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NORRIS CANYON RD STE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835440",
            "telephone_number": "925-830-8823",
            "fax_number": "925-866-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NORRIS CANYON ROAD",
            "address_2": "SUITE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835406",
            "telephone_number": "925-830-8823",
            "fax_number": "925-866-6610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8440 Brentwood Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "CA",
            "postal_code": "945131300",
            "country_code": "US",
            "telephone_number": "925-701-8824",
            "fax_number": "925-866-6610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST BAY EYE CENTERS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "925-830-2112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ05706Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ057067",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.