Central Coast Eye, Inc., a Professional Medical Corporation

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

A38558 Issued in CA

Legal business name

CENTRAL COAST EYE, INC., A PROFESSIONAL MEDICAL CORPORATION

Doing business as

Central Coast Eye

Practice address

628 California Blvd Ste C
San Luis Obispo, CA 93401-2547

Phone

(805) 547-2090

NPI assigned

Jul 24, 2017

Organization subpart

No

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

Authorized official

Name

Steven C Johnson, M.D.NPI 1679581581

Title

President

Phone

(805) 547-2090

Specialties & licenses 1

Addresses

Other names 1

• Central Coast Eye Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: sjohnson@cce.intellechartdirect.net

Practitioners 2

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

• Steven C Johnson, MD

  • Ophthalmology Physician
  • San Luis Obispo, CA
  • NPI 1679581581
  Medicare reassignment NPD Authorized official
• Sharon M Theodore, M.D.

  • Ophthalmology Physician
  • Pismo Beach, CA
  • NPI 1831145739
  Medicare reassignment NPD

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992228795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CALIFORNIA BLVD STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012547",
            "telephone_number": "805-547-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CALIFORNIA BLVD STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012547",
            "telephone_number": "805-547-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST EYE, INC., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-547-2090",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A38558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Coast Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Central Coast Employee Assistance & Counseling Services
• Central Coast Eye Associates Inc
• Central Coast Eye Surgery, Inc., a Professional Medical Corporation
• Central Coast Home Health Inc
• Central Coast Home Health Inc
• Central Coast Home Health, Inc.
• Central Coast Imaging, P.C.-Raytel Medical Imaging
• Central Coast Institute for Plastic Surgery, AMC

• Retina Specialist (Ophthalmology) Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.