Active NPI
Pacific Eye Institute, a Medical Group, Inc.
- Ophthalmology Physician
- Upland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- PACIFIC EYE INSTITUTE, A MEDICAL GROUP, INC.
- Practice address
- 555 N 13TH Ave
Upland, CA 91786-4904 - Phone
- (909) 982-8846
- Fax
- (909) 949-3967
- NPI assigned
- Jul 21, 2006
- Last updated
- Mar 13, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dante Cervantes
- Title
- Medical Staff Services Specialist
- Phone
- (909) 277-2420
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
555 N 13TH Ave
Upland, CA 91786-4904
Mailing address
555 N 13TH Ave
Upland, CA 91786-4904
Phone (909) 982-8846
Other practice location 1
500 E Mountain View St
Barstow, CA 92311-2937
Phone (800) 645-8979
Other practice location 2
11959 Mariposa Rd
Hesperia, CA 92345-1696
Phone (800) 345-8979
Other practice location 3
930 W Main St
Barstow, CA 92311-2654
Phone (800) 345-8979
Other practice location 4
9834 Genesee Ave Ste 200
LA Jolla, CA 92037-1225
Phone (858) 457-3050
Other practice location 5
16177 Kamana Rd
Apple Valley, CA 92307-1377
Phone (760) 946-0618
Other practice location 6
9834 Genesee Ave Ste 428
LA Jolla, CA 92037-1264
Phone (800) 765-2737
Other practice location 7
8112 Milliken Ave Ste 203
Rancho Cucamonga, CA 91730-7473
Phone (800) 345-8979
Other practice location 8
700 W El Norte Pkwy
Escondido, CA 92026-3923
Phone (800) 765-2737
Other practice location 9
1900 E Washington St
Colton, CA 92324-4614
Phone (800) 645-8979
Other practice location 10
12442 Limonite Ave Unit 200
Eastvale, CA 91752-2467
Phone (800) 345-8979
Other practice location 11
6216 Brockton Ave Ste 214
Riverside, CA 92506-2223
Phone (951) 686-1190
Other practice location 12
340 S Farrell Dr Bldg 105
Palm Springs, CA 92262-7963
Phone (760) 327-6225
Other practice location 13
591 N 13th Ave
Upland, CA 91786-4967
Phone (800) 345-8979
Other practice location 14
5330 Carroll Canyon Rd Ste 210
San Diego, CA 92121-3758
Phone (800) 765-2737
Other practice location 15
3939 3rd Ave
San Diego, CA 92103-3002
Phone (858) 450-1010
Other practice location 16
41877 Enterprise Cir N Ste 110
Temecula, CA 92590-5628
Phone (800) 345-8979
Other practice location 17
591 N 13th Ave Ste 3
Upland, CA 91786-4968
Phone (800) 345-8979
Other practice location 18
40055 Bob Hope Dr Ste J
Rancho Mirage, CA 92270-3940
Phone (760) 346-5005
Other practice location 19
15099 Kamana Rd
Apple Valley, CA 92307-1388
Phone (800) 345-8979
Other practice location 20
3637 Vista Way
Oceanside, CA 92056-4522
Phone (760) 758-2008
Other practice location 21
36949 Cook St Ste 101
Palm Desert, CA 92211-6080
Phone (760) 340-2394
Other practice location 22
9481 Haven Ave Ste 200
Rancho Cucamonga, CA 91730-5811
Phone (909) 937-9230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041004001187 | CA | Part B Supplier - Clinic/Group Practice | 7911966122 |
Receives reassigned benefits from 51 practitioners Practice locations: Palm Desert, CA; Temecula, CA; Palm Springs, CA; Rancho Cucamonga, CA; Rancho Mirage, CA; San Diego, CA; Upland, CA; Los Angeles, CA… |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Ambulatory Surgical Clinic/Center
- Upland, CA
- NPI 1407932619
7911966122
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2054597 | Pacific Eye Institute | Certificate of waiver | Feb 24, 2027 |
| 05D2055342 | Pacific Eye Institute | Certificate of waiver | Mar 7, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Pacific Eye Institute a Medical Group Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmology Physician
- Apple Valley, CA
- NPI 1316680200
Locations
15099 Kamana Rd
Apple Valley, CA 92307
700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830
11959 Mariposa Rd
Hesperia, CA 92345
Phone (760) 956-1100
700 W El Norte Pkwy
Los Angeles, CA 90084
340 S Farrell Dr
Bldg 105
Palm Springs, CA 92262
Phone (760) 327-6225
1455 E 3rd St
Pomona, CA 91766
3939 3rd Ave
Ste B
San Diego, CA 92103
5330 Carroll Canyon Rd
Ste 21
San Diego, CA 92121
5330 Carroll Canyon Rd
Ste 210
San Diego, CA 92121
Phone (800) 765-2737
41877 Enterprise Cir N
Ste 100
Temecula, CA 92590
Phone (651) 676-4393
591 N 13th Ave
Ste 1
Upland, CA 91786
Phone (909) 946-5320
591 N 13th Ave
Ste 2
Upland, CA 91786
Phone (909) 946-6209
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- abutler@pacificeyelaser.intellechartdirect.net
- amorton@pacificeyelaser.intellechartdirect.net
- cberkowitz@pacificeyelaser.intellechartdirect.net
- cchan@pacificeyelaser.intellechartdirect.net
- ckytasty@pacificeyelaser.intellechartdirect.net
- clee@pacificeyelaser.intellechartdirect.net
- cng@pacificeyelaser.intellechartdirect.net
- csheils@pacificeyelaser.intellechartdirect.net
- dhanna@pacificeyelaser.intellechartdirect.net
- dmatsunaga@pacificeyelaser.intellechartdirect.net
- dmichelson@pacificeyelaser.intellechartdirect.net
- ffaramarzi@pacificeyelaser.intellechartdirect.net
- jbokosky@pacificeyelaser.intellechartdirect.net
- jremulla@pacificeyelaser.intellechartdirect.net
- kprendiville@pacificeyelaser.intellechartdirect.net
- ksatterfield@pacificeyelaser.intellechartdirect.net
- mdaniel@pacificeyelaser.intellechartdirect.net
- mhenao@pacificeyelaser.intellechartdirect.net
- mkirk@pacificeyelaser.intellechartdirect.net
- mshaaf@pacificeyelaser.intellechartdirect.net
Practitioners & affiliated clinicians
Practitioners 50
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.
-
- Optometrist
- Upland, CA
- NPI 1356017321
-
- Ophthalmology Physician
- San Diego, CA
- NPI 1801275391
-
- Ophthalmology Physician
- Los Angeles, CA
- NPI 1174938062
-
- Ophthalmology Physician
- Upland, CA
- NPI 1225135288
-
- Ophthalmology Physician
- Upland, CA
- NPI 1740468263
-
- Ophthalmology Physician
- San Diego, CA
- NPI 1578928669
-
- Ophthalmology Physician
- Upland, CA
- NPI 1043849078
-
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Santa Clarita, CA
- NPI 1497959332
Ophthalmology
-
- Ophthalmology Physician
- Colton, CA
- NPI 1336142892
-
- Optometrist
- Oceanside, CA
- NPI 1386932374
-
- Ophthalmology Physician
- Palm Desert, CA
- NPI 1588083547
-
- Retina Specialist (Ophthalmology) Physician
- Palm Desert, CA
- NPI 1336131408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773360000000",
"number": "1962422709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 N 13TH AVE",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864904",
"telephone_number": "909-982-8846",
"fax_number": "909-949-3967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 N 13TH AVE",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864904",
"telephone_number": "909-982-8846",
"fax_number": "909-949-3967"
}
],
"practiceLocations": [
{
"address_1": "500 E Mountain View St",
"address_purpose": "LOCATION",
"city": "Barstow",
"state": "CA",
"postal_code": "923112937",
"country_code": "US",
"telephone_number": "800-645-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11959 Mariposa Rd",
"address_purpose": "LOCATION",
"city": "Hesperia",
"state": "CA",
"postal_code": "923451696",
"country_code": "US",
"telephone_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "930 W Main St",
"address_purpose": "LOCATION",
"city": "Barstow",
"state": "CA",
"postal_code": "923112654",
"country_code": "US",
"telephone_number": "800-345-8979",
"fax_number": "909-949-3967",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9834 Genesee Ave Ste 200",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920371225",
"country_code": "US",
"telephone_number": "858-457-3050",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16177 Kamana Rd",
"address_purpose": "LOCATION",
"city": "Apple Valley",
"state": "CA",
"postal_code": "923071377",
"country_code": "US",
"telephone_number": "760-946-0618",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9834 Genesee Ave Ste 428",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920371264",
"country_code": "US",
"telephone_number": "800-765-2737",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8112 Milliken Ave Ste 203",
"address_purpose": "LOCATION",
"city": "Rancho Cucamonga",
"state": "CA",
"postal_code": "917307473",
"country_code": "US",
"telephone_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "700 W El Norte Pkwy",
"address_purpose": "LOCATION",
"city": "Escondido",
"state": "CA",
"postal_code": "920263923",
"country_code": "US",
"telephone_number": "800-765-2737",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1900 E Washington St",
"address_purpose": "LOCATION",
"city": "Colton",
"state": "CA",
"postal_code": "923244614",
"country_code": "US",
"telephone_number": "800-645-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12442 Limonite Ave Unit 200",
"address_purpose": "LOCATION",
"city": "Eastvale",
"state": "CA",
"postal_code": "917522467",
"country_code": "US",
"telephone_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6216 Brockton Ave Ste 214",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925062223",
"country_code": "US",
"telephone_number": "951-686-1190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "340 S Farrell Dr Bldg 105",
"address_purpose": "LOCATION",
"city": "Palm Springs",
"state": "CA",
"postal_code": "922627963",
"country_code": "US",
"telephone_number": "760-327-6225",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "591 N 13th Ave",
"address_purpose": "LOCATION",
"city": "Upland",
"state": "CA",
"postal_code": "917864967",
"country_code": "US",
"telephone_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5330 Carroll Canyon Rd Ste 210",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921213758",
"country_code": "US",
"telephone_number": "800-765-2737",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3939 3rd Ave",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921033002",
"country_code": "US",
"telephone_number": "858-450-1010",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "41877 Enterprise Cir N Ste 110",
"address_purpose": "LOCATION",
"city": "Temecula",
"state": "CA",
"postal_code": "925905628",
"country_code": "US",
"telephone_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "591 N 13th Ave Ste 3",
"address_purpose": "LOCATION",
"city": "Upland",
"state": "CA",
"postal_code": "917864968",
"country_code": "US",
"telephone_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40055 Bob Hope Dr Ste J",
"address_purpose": "LOCATION",
"city": "Rancho Mirage",
"state": "CA",
"postal_code": "922703940",
"country_code": "US",
"telephone_number": "760-346-5005",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15099 Kamana Rd",
"address_purpose": "LOCATION",
"city": "Apple Valley",
"state": "CA",
"postal_code": "923071388",
"country_code": "US",
"telephone_number": "800-345-8979",
"fax_number": "800-345-8979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3637 Vista Way",
"address_purpose": "LOCATION",
"city": "Oceanside",
"state": "CA",
"postal_code": "920564522",
"country_code": "US",
"telephone_number": "760-758-2008",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "36949 Cook St Ste 101",
"address_purpose": "LOCATION",
"city": "Palm Desert",
"state": "CA",
"postal_code": "922116080",
"country_code": "US",
"telephone_number": "760-340-2394",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9481 Haven Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Rancho Cucamonga",
"state": "CA",
"postal_code": "917305811",
"country_code": "US",
"telephone_number": "909-937-9230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PACIFIC EYE INSTITUTE, A MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-21",
"last_updated": "2026-03-13",
"certification_date": "2026-03-13",
"status": "A",
"authorized_official_last_name": "CERVANTES",
"authorized_official_first_name": "DANTE",
"authorized_official_title_or_position": "MEDICAL STAFF SERVICES SPECIALIST",
"authorized_official_telephone_number": "909-277-2420"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.