Center for Sight of Stockton a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CENTER FOR SIGHT OF STOCKTON A MEDICAL CORPORATION

Practice address

1208 Floyd Ave BLDG D
Modesto, CA 95350-2470

Phone

(209) 622-2700

Fax

(209) 622-2710

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Philip A Edington, MDNPI 1508837279

Title

Director

Phone

(209) 948-5515

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Stockton, CA
  • NPI 1326062084

  2264499037

  Same PAC ID

Other NPIs on the same Medicare enrollment 3

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

• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Manteca, CA
  • NPI 1013931781

  O20050714000703

  Same enrollment
• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Tracy, CA
  • NPI 1114941796

  O20050714000703

  Same enrollment
• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Stockton, CA
  • NPI 1326062084

  O20050714000703

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 5

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

• Philip A Edington, M.D.

  • Specialist
  • Stockton, CA
  • NPI 1508837279
  Medicare reassignment Care Compare group NPD Authorized official
• Charles Kim, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Stockton, CA
  • NPI 1104242924
  Medicare reassignment Care Compare group NPD
• Majid Roubach, M.D.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Stockton, CA
  • NPI 1639550130
  Medicare reassignment Care Compare group NPD
• Daniel Wee, M.D.

  • Ophthalmology Physician
  • Stockton, CA
  • NPI 1740480441
  Medicare reassignment Care Compare group NPD
• Jennifer Pham, O.D.

  • Optometrist
  • Stockton, CA
  • NPI 1104369123
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1962426643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1899 W. MARCH LANE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076402",
            "telephone_number": "209-623-4700",
            "fax_number": "209-623-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 FLOYD AVE BLDG D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953502470",
            "telephone_number": "209-622-2700",
            "fax_number": "209-622-2710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 W. H STREET",
            "address_2": "SUITE 340",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "CA",
            "postal_code": "953613572",
            "country_code": "US",
            "telephone_number": "209-847-2780",
            "fax_number": "209-847-2748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR SIGHT OF STOCKTON A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "EDINGTON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "209-948-5515",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "ZZZ23858Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Modesto, CA
• Providers in Modesto, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.