Preethi Thiagarajan, O.D., PH.D., FAAO

Primary specialty

OptometristTaxonomy code 152W00000X

License

5378 Issued in MA

Practice address

15051 Hesperian Blvd Ste a
San Leandro, CA 94578-3536

Phone

(646) 330-9068

NPI assigned

Jun 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Family Eye Care, Inc.

  • Optometrist
  • Spencer, MA
  • NPI 1245652866
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1841851045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15051 HESPERIAN BLVD STE A",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783536",
            "telephone_number": "646-330-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15051 HESPERIAN BLVD STE A",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783536",
            "telephone_number": "646-330-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIAGARAJAN",
        "first_name": "PREETHI",
        "name_prefix": "Dr.",
        "credential": "O.D., PH.D., FAAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5378",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Alliance for Community Wellness
• The Davis Street Community Center Incorporated
• The Resource Environment for Underprivileged Groups Enterprise, Inc.
• The Unity Care Group
• Rylan Thew
• Justin Lee Thiel
• Andrea Thoele
• Ebonee Chantayle Thomas Hancox
• Jillian Coleen Thomas Polyak, AMFT
• Ayanna Thomas

• Optometrist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.