NPIMap

Organization Active NPI

California Eye Clinic

  • Ophthalmology Physician
  • Brentwood, CA
National Provider Identifier
1982749933
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CALIFORNIA EYE CLINIC
Practice address
1181 Central Blvd
Suite F
Brentwood, CA 94513-2278
Phone
(925) 516-0888
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly Creighton
Title
Bookkeeping Manager
Phone
(925) 754-2625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

1181 Central Blvd
Suite F
Brentwood, CA 94513-2278

Mailing address

1181 Central Blvd
Brentwood, CA 94513-2278
Phone (925) 516-0888

Other identifiers 1

IdentifierTypeStateIssuer
GR0018432MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040818000506 CA Part B Supplier - Clinic/Group Practice 9931092962 Receives reassigned benefits from 13 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Ramon, CA; Walnut Creek, CA; Brentwood, CA; Antioch, CA; Pittsburg, CA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
California Eye Clinic9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982749933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 CENTRAL BLVD",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132278",
            "telephone_number": "925-516-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 CENTRAL BLVD",
            "address_2": "SUITE F",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132278",
            "telephone_number": "925-516-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CREIGHTON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BOOKKEEPING MANAGER",
        "authorized_official_telephone_number": "925-754-2625"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0018432",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.