Capital Eye Medical Group

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

C52250 Issued in CA

Legal business name

CAPITAL EYE MEDICAL GROUP

Practice address

9221 Sierra College Blvd
Suite 130
Roseville, CA 95661-5919

Phone

(916) 797-6747

Fax

(916) 797-6728

NPI assigned

Sep 6, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mitra Ayazifar, M.D.NPI 1972520641

Title

President

Phone

(916) 960-9176

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Capital Eye Medical Group

  • Ophthalmology Physician
  • Jackson, CA
  • NPI 1568893659

  O20111209000146

  Same enrollment
• Capital Eye Medical Group

  • Ophthalmology Physician
  • Grass Valley, CA
  • NPI 1780234419

  O20111209000146

  Same enrollment

Practitioners 1

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

• Mitra Ayazifar, MD

  • Ophthalmology Physician
  • Roseville, CA
  • NPI 1972520641
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1962783928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9221 SIERRA COLLEGE BLVD",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615919",
            "telephone_number": "916-797-6747",
            "fax_number": "916-797-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9221 SIERRA COLLEGE BLVD",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615919",
            "telephone_number": "916-797-6747",
            "fax_number": "916-797-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL EYE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "AYAZIFAR",
        "authorized_official_first_name": "MITRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-960-9176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C52250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jelena Canter, RDHAP, BS.
• Enrique Canto
• Lieu Thi Cao, D.D.S.
• Alyssa Capdevila
• Aimee Colleen Capello, PT
• Capitol City Psychiatry
• Capitol Dental Hygiene
• Capitol Gastroenterology Consultants Medical Group, Inc.
• Capitol Periodontal Group
• Francis Joseph Capobianco Jr., M.D.

• Ophthalmology Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.