Active NPI
Thomas Cavanaugh, O.D.
- Optometrist
- Auburn, CA
National Provider Identifier
1942379664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 5370 TPA
- Practice address
- 3133 Professional Dr
Suite 14
Auburn, CA 95603-2463 - Phone
- (530) 888-0670
- Fax
- (530) 888-8652
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 5370 TPA | CA | Primary |
| Pediatric Optometrist | 152WP0200X | OPT 5370 TPA | CA | |
| Sports Vision Optometrist | 152WS0006X | OPT 5370 TPA | CA | |
| Occupational Vision Optometrist | 152WX0102X | OPT 5370 TPA | CA | |
| Contact Lens Fitter | 156FC0801X | OPT 5370 TPA | CA |
Addresses
Primary practice location
3133 Professional Dr
Suite 14
Auburn, CA 95603-2463
Mailing address
3133 Professional Dr
Suite 14
Auburn, CA 95603-2463
Phone (530) 888-0670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 5370 TPA | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1942379664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3133 PROFESSIONAL DR",
"address_2": "SUITE 14",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032463",
"telephone_number": "530-888-0670",
"fax_number": "530-888-8652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3133 PROFESSIONAL DR",
"address_2": "SUITE 14",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032463",
"telephone_number": "530-888-0670",
"fax_number": "530-888-8652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 5370 TPA",
"primary": true
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "CA",
"license": "OPT 5370 TPA",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "CA",
"license": "OPT 5370 TPA",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "CA",
"license": "OPT 5370 TPA",
"primary": false
},
{
"code": "156FC0801X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Contact Lens Fitter",
"state": "CA",
"license": "OPT 5370 TPA",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.