Individual provider Active NPI

Patricia A Ebright, O.D.

  • Optometrist
  • Vallejo, CA
National Provider Identifier
1861407538
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10848T Issued in CA
Practice address
127 Hospital Dr
Ste 201
Vallejo, CA 94589-2500
Phone
(707) 554-3101
Fax
(707) 554-2402
NPI assigned
Jul 30, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10848T CA Primary

Addresses

Primary practice location

127 Hospital Dr
Ste 201
Vallejo, CA 94589-2500

Mailing address

127 Hospital Dr
Ste 201
Vallejo, CA 94589-2500
Phone (707) 554-3101

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
I20070827000876 CA Practitioner - Optometry 0648362293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patricia Ebright OD IncGroup PAC ID 9739482092, 2 clinicians

Practice addresses (Care Compare)

127 Hospital Dr
Suite 201
Vallejo, CA 94589-2500
Phone (707) 554-3101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10848TCAMDOptometrist

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1861407538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 HOSPITAL DR",
            "address_2": "STE 201",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892500",
            "telephone_number": "707-554-3101",
            "fax_number": "707-554-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 HOSPITAL DR",
            "address_2": "STE 201",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892500",
            "telephone_number": "707-554-3101",
            "fax_number": "707-554-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRIGHT",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10848T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.