Individual provider Active NPI

Paul Rene Perron, O.D

  • Optometrist
  • Roseville, CA
National Provider Identifier
1780731638
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10261T Issued in CA
Practice address
1213 Pleasant Grove Blvd
Roseville, CA 95678-6989
Phone
(916) 789-1959
Fax
(916) 789-1961
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10261T CA Primary

Addresses

Primary practice location

1213 Pleasant Grove Blvd
Roseville, CA 95678-6989

Mailing address

1213 Pleasant Grove Blvd
Roseville, CA 95678-6971
Phone (916) 789-1959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060502000843 CA Practitioner - Optometry 4880604057 Reassigns benefits to 1 organization
Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1213 Pleasant Grove Blvd
Roseville, CA 95678-6989
Phone (916) 789-1959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10261TCAMDOptometrist
10261CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roseville Vision Center Inc an Optometric Corporation CurrentSince Feb 12, 2020 Accepting new patients

Locations

1213 Pleasant Grove Blvd
Roseville, CA 95678
Phone (916) 789-1959

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1780731638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 PLEASANT GROVE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786971",
            "telephone_number": "916-789-1959",
            "fax_number": "916-789-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 PLEASANT GROVE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786989",
            "telephone_number": "916-789-1959",
            "fax_number": "916-789-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRON",
        "first_name": "PAUL",
        "middle_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10261T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.