Individual provider Active NPI

Ryan Vikesland, OD

  • Optometrist
  • Chico, CA
National Provider Identifier
1902336076
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33680 Issued in CA
Practice address
114 Mission Ranch Blvd Ste 50
Chico, CA 95926-5137
Phone
(530) 891-1900
Fax
(530) 895-1531
NPI assigned
Jun 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33680 CA Primary

Addresses

Primary practice location

114 Mission Ranch Blvd Ste 50
Chico, CA 95926-5137

Mailing address

114 Mission Ranch Blvd Ste 50
Chico, CA 95926-5137
Phone (530) 891-1900

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
I20170714001383 CA Practitioner - Optometry 3173893724 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

1333 Chestnut Ave
Long Beach, CA 90813-2944
Phone (562) 753-2315

Hospital & facility affiliations

  • Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33680CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecon Optometry Partnership Optometrist CurrentSince Sep 15, 2024 Accepting new patients
County of Los Angeles CurrentSince Sep 16, 2019 Accepting new patients
County of Los Angeles CurrentSince Sep 16, 2019 Accepting new patients
Advanced Vision Care a California General Partnership CurrentSince Apr 23, 2019 Accepting new patients
County of Los Angeles Current Accepting new patients
North Valley Eye Care Optometrist Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1333 Chestnut Ave
Long Beach, CA 90813
Phone (562) 599-8601

2080 Century Park E
Ste 911
Los Angeles, CA 90067
Phone (310) 229-1220

7217 Reseda Blvd
Reseda, CA 91335
Phone (818) 345-2010

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1902336076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MISSION RANCH BLVD STE 50",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959265137",
            "telephone_number": "530-891-1900",
            "fax_number": "530-895-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MISSION RANCH BLVD STE 50",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959265137",
            "telephone_number": "530-891-1900",
            "fax_number": "530-895-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIKESLAND",
        "first_name": "RYAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.