Individual provider Active NPI

Alexander F. Goncalves, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1992895403
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 7198 TPA Issued in CA
Practice address
2131 Capitol Ave
Suite 107
Sacramento, CA 95816-5755
Phone
(916) 446-0125
Fax
(916) 446-3586
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 7198 TPA CA Primary

Addresses

Primary practice location

2131 Capitol Ave
Suite 107
Sacramento, CA 95816-5755

Mailing address

2131 Capitol Ave
Suite 107
Sacramento, CA 95816-5755
Phone (916) 446-0125

Other identifiers 3

IdentifierTypeStateIssuer
SD0071980MedicaidCA
02812OtherCAMEDICAL EYE SERVICES
3954390001OtherCANORIDIAN

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
I20101015000074 CA Practitioner - Optometry 6406049030 Reassigns benefits to 1 organization
Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Third Optometric Care of CaliforniaGroup PAC ID 8325456536, 16 clinicians

Practice addresses (Care Compare)

2131 Capitol Ave
Suite 107
Sacramento, CA 95816-5755
Phone (916) 446-0125

400 O St
Suite 102
Sacramento, CA 95814-5327
Phone (916) 443-3524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7198CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Third Optometric Care of California Optometrist CurrentSince Aug 30, 2021 Accepting new patients
Third Optometric Care of California PC Optometrist CurrentSince Aug 30, 2021 Accepting new patients
Third Optometric Care of California Optometrist Past Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

400 O St
Ste 102
Sacramento, CA 95814
Phone (916) 443-3524

2131 Capitol Ave
Ste 107
Sacramento, CA 95816
Phone (916) 446-0125

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992895403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 CAPITOL AVE",
            "address_2": "SUITE 107",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165755",
            "telephone_number": "916-446-0125",
            "fax_number": "916-446-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 CAPITOL AVE",
            "address_2": "SUITE 107",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165755",
            "telephone_number": "916-446-0125",
            "fax_number": "916-446-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCALVES",
        "first_name": "ALEXANDER",
        "middle_name": "F.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 7198 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0071980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "02812",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORIDIAN",
            "identifier": "3954390001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.