Bruce Calvin Brockman, O.D.
Individual provider Active NPI Optometrist · Ojai, CA
NPI 1922012632 · NPPES record last updated May 29, 2014
Key facts
- NPI
- 1922012632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 7932T (CA)
- Practice address
- 1211 Maricopa Hwy.
Ste. 101
Ojai, CA 93023 - Phone
- (805) 646-5109
- Fax
- (805) 646-3519
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1211 Maricopa Hwy
Suite 101
Ojai, CA 93023-3165
Phone (805) 646-5109
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100723000366 | CA | Practitioner - Optometry | 9739211905 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7932T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Topa Topa Optometry, Inc | Optometrist | Current |
Accepting new patients |
| Third Optometric Care of California | Optometrist | Current | Accepting new patients |
| Third Optometric Care of California PC | Optometrist | Current |
Accepting new patients |
| Third Optometric Care of California | Optometrist | Current |
Accepting new patients |
| Third Optometric Care of California PC | Optometrist | Past | Accepting new patients |
Locations
1211 Maricopa Hwy
Ste 101
Ojai, CA 93023
Phone (805) 646-5109
3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564
400 O St
Ste 102
Sacramento, CA 95814
Phone (916) 443-3524
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7932T | CA | Yes |
Addresses
Primary practice location
1211 Maricopa Hwy.
Ste. 101
Ojai, CA 93023
Mailing address
1211 Maricopa Hwy.
Ste. 101
Ojai, CA 93023
Phone (805) 646-5109
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0079320 | Medicaid | CA |
Other providers in Ojai, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.