Individual provider Active NPI

Mahnoush Rafat, OD

  • Optometrist
  • Citrus Heights, CA
National Provider Identifier
1972244218
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35115 Issued in CA
Practice address
5959 Greenback LN Ste 120&130
Citrus Heights, CA 95621-4700
Phone
(916) 726-1818
NPI assigned
Apr 1, 2022
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Vision Optometrist 152WS0006X 35115 CA
Vision Therapy Optometrist 152WV0400X 35115 CA
Optometrist 152W00000X 35115 CA Primary

Addresses

Primary practice location

5959 Greenback LN Ste 120&130
Citrus Heights, CA 95621-4700

Mailing address

2401 Ruby CT
Rocklin, CA 95677-4224
Phone (916) 420-6506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220513001628 CA Practitioner - Optometry 5597142448 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5959 Greenback LN
Suite 130
Citrus Heights, CA 95621-4700
Phone (916) 726-1818

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35115CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin G. Lockhart, O.D., Inc Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Eye Center Optometrics, a Professional Corporation Optometrist CurrentSince Apr 1, 2022 Accepting new patients
El Dorado Hills Vision Center Optometry Inc. Optometrist CurrentSince Jul 20, 2023 Accepting new patients
Granite Bay Vision Center Optometry, Inc. Optometrist CurrentSince Aug 1, 2023 Accepting new patients
Eye Center Optometrics, a Professional Corporation Optometrist CurrentSince Apr 1, 2022 Accepting new patients
Eye Center Optometrics, a Professional Corporation Optometrist Past Accepting new patients
First Optometric Care of Northern California PC Optometrist Past Accepting new patients
Eyecenter Optometrics, a Professional Corporation Optometrist Past Accepting new patients

Locations

5959 Greenback Ln
Ste 130
Citrus Hts, CA 95621
Phone (916) 726-1818

3955 Park Dr
Ste 1
El Dorado Hills, CA 95762
Phone (916) 292-5666

421 Blue Ravine Rd
Ste 300
Folsom, CA 95630
Phone (916) 452-4706

2200 Sunrise Blvd
Ste 120
Gold River, CA 95670
Phone (916) 852-1600

5520 Douglas Blvd
Ste 110
Granite Bay, CA 95746
Phone (916) 791-5490

6809 Five Star Blvd
Ste 100A
Rocklin, CA 95677
Phone (916) 624-2020

2831 J St
Sacramento, CA 95816
Phone (916) 441-5800

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1972244218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 RUBY CT",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956774224",
            "telephone_number": "916-420-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 GREENBACK LN STE 120&130",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956214700",
            "telephone_number": "916-726-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAT",
        "first_name": "MAHNOUSH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "35115",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "35115",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.