Individual provider Active NPI

Cristal Maharaj

  • Optometrist
  • Fresno, CA
National Provider Identifier
1790466068
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35917-TLG Issued in CA
Practice address
7825 N Blackstone Ave Ste 101
Fresno, CA 93720-4347
Phone
(559) 500-7685
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35917-TLG CA Primary

Addresses

Primary practice location

7825 N Blackstone Ave Ste 101
Fresno, CA 93720-4347

Mailing address

2615 E Clinton Avenue
Eye Clinic 11
Fresno, CA 93703-2223

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
I20250620003361 CA Practitioner - Optometry 2163934696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avani Patel Optometric CorporationGroup PAC ID 1052780632, 12 clinicians

Practice addresses (Care Compare)

7825 N Blackstone Ave
Fresno, CA 93720-4345
Phone (510) 457-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35917-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc CurrentSince Apr 11, 2025 Accepting new patients
Avani Patel Optometric Corporation Optometrist CurrentSince Apr 11, 2025 Accepting new patients

Locations

4983 N Blackstone Ave
Fresno, CA 93726
Phone (510) 731-7873

7825 N Blackstone Ave
Ste 101
Fresno, CA 93720
Phone (559) 500-7685

7825 N Blackstone Ave
Fresno, CA 93720
Phone (510) 457-6300

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1790466068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E CLINTON AVENUE",
            "address_2": "EYE CLINIC 11",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 N BLACKSTONE AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204347",
            "telephone_number": "559-500-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHARAJ",
        "first_name": "CRISTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35917-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.