Midpeninsula Ophthalmology Medical Group Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

MIDPENINSULA OPHTHALMOLOGY MEDICAL GROUP INC

Practice address

1225 Crane St
Suite 200
Menlo Park, CA 94025-4257

Phone

(650) 324-0056

Fax

(650) 324-1156

NPI assigned

Dec 29, 2006

Last updated

Jun 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judith Nevitt, MD

Title

President

Phone

(650) 324-0056

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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.

• Anupam Jayaram, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Menlo Park, CA
  • NPI 1174803944
  Medicare reassignment NPD
• Clare C Siu, MD

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1568579019
  NPD

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1861558157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CRANE ST",
            "address_2": "SUITE 200",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254257",
            "telephone_number": "650-324-0056",
            "fax_number": "650-324-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CRANE ST",
            "address_2": "SUITE 200",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254257",
            "telephone_number": "650-324-0056",
            "fax_number": "650-324-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDPENINSULA OPHTHALMOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "NEVITT",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-324-0056",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Michaels
• Charlie Michaudet, MD
• Mid-Peninsula Hand Rehabilitation & Ergonomics
• Mid-Peninsula Optical
• Kathryn Noel Middleton, DO
• Gladys Miguel
• Maria Mikoyan
• Marcela Millan, M.D.
• McKenzie L Miller, PHD
• Tara D Miller, MD

• Ophthalmology Physician in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.