NPIMap

Organization Active NPI

California Retina Consultants

  • Retina Specialist (Ophthalmology) Physician
  • Paso Robles, CA
National Provider Identifier
1891086294
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
CALIFORNIA RETINA CONSULTANTS
Practice address
104 Gateway Center Dr
Ste B
Paso Robles, CA 93446-3752
Phone
(805) 237-1610
Fax
(805) 880-5915
NPI assigned
Apr 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Robert Avery, MD
Title
Ceo
Phone
(805) 963-1648

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

104 Gateway Center Dr
Ste B
Paso Robles, CA 93446-3752

Mailing address

525 E Micheltorena St
Suite a
Santa Barbara, CA 93103-2254
Phone (805) 963-1648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001116 CA Part B Supplier - Clinic/Group Practice 6608860135 Receives reassigned benefits from 16 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Palmdale, CA; Westlake Village, CA; Valencia, CA; Simi Valley, CA; Santa Maria, CA; San Luis Obispo, CA; Paso Robles, CA; Oxnard, CA…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
California Retina Consultants10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

  • Nika Bagheri, M.D.
    • Retina Specialist (Ophthalmology) Physician
    • Simi Valley, CA
    • NPI 1790040087

    Retina Specialist

    NPD

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1891086294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MICHELTORENA ST",
            "address_2": "SUITE A",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931032254",
            "telephone_number": "805-963-1648",
            "fax_number": "805-965-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GATEWAY CENTER DR",
            "address_2": "STE B",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934463752",
            "telephone_number": "805-237-1610",
            "fax_number": "805-880-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA RETINA CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-963-1648",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.