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EAST BAY RETINA CONSULTANTS, INC.
NPI 1124319959
Ophthalmology in Concord, CA

Active since April 27, 2011CLIA 05D1071572 · Waiver
1401 WILLOW PASS RD, SUITE 120, CONCORD, CA 94520(925) 680-1600(925) 680-1602 Get Directions Write a Review

NPPES record last updated: February 29, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About East Bay Retina Consultants, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST BAY RETINA CONSULTANTS, INC. (NPI 1124319959) is a healthcare organization registered as an ophthalmology in Concord, California and active in the NPI registry since April 2011. The organization holds a CLIA Waiver certificate valid through July 26, 2027 and lists Soon T Lee, Corporate Vice President, as its authorized official.

NPPES Registry Identity

NPI1124319959
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameEAST BAY RETINA CONSULTANTS A MEDICAL GROUP, INC.
Location Address1401 WILLOW PASS RD, SUITE 120Concord, CA 94520-7982
Mailing Address3300 Telegraph AveOakland, CA 94609-3028 · (510) 444-1600 · Fax (510) 444-1828
Phone(925) 680-1600
Fax(925) 680-1602
Organization SubpartNo
Authorized OfficialSoon T LeeCorporate Vice President · (510) 444-1600
Enumeration DateApril 27, 2011
Last NPPES UpdateFebruary 29, 2016
✔ NPI 1124319959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in CA · A44312
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1401 WILLOW PASS RD, Concord, CA 94520
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Other Names 1

Doing Business AsEast Bay Retina Consultants, Inc.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

East Bay Retina Consultants, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to East Bay Retina Consultants, Inc., which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (7)

Alexander Dillon, M.D.
Ophthalmology
NPI 1699120212
975 SERENO DR
Vallejo, CA 94589
(707) 651-1042
✔ PECOS✔ Accepts Medicare15 mi
Daniel Brinton, M.D.
Ophthalmology
NPI 1114919495
3300 TELEGRAPH AVE
Oakland, CA 94609
(510) 444-1600
✔ PECOS✔ Accepts Medicare16 mi
William Carrera, M.D.
Ophthalmology
NPI 1679014013
3300 TELEGRAPH AVE
Oakland, CA 94609
(510) 444-1600
✔ PECOS✔ Accepts Medicare16 mi
Jesse Jung, MD
Ophthalmology
NPI 1033351689
3300 TELEGRAPH AVE
Oakland, CA 94609
(510) 444-1600
✔ PECOS✔ Accepts Medicare16 mi
Eugene Lit, M.D.
Ophthalmology
NPI 1336132919
3300 TELEGRAPH AVE
Oakland, CA 94609
(510) 444-1600
✔ PECOS✔ Accepts Medicare16 mi
Soraya Rofagha, MD
Ophthalmology
NPI 1568687374
3300 TELEGRAPH AVE
Oakland, CA 94609
(510) 444-1600
✔ PECOS✔ Accepts Medicare16 mi
Soon Lee, M.D.
Ophthalmology
NPI 1952394553
3300 TELEGRAPH AVE
Oakland, CA 94609
(510) 444-1600
✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1071572

East Bay Retina Consultants, Inc · Oakland, CA
Active · expires Jul 26, 2027
CLIA Number05D1071572
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2025
Certificate Expiration DateJuly 26, 2027
Laboratory DirectorEugene S. Lit, MD
Laboratory Phone(510) 444-1600
Laboratory LocationEast Bay Retina Consultants, Inc3300 Telegraph Avenue, Oakland, CA 94609
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Bay Retina Consultants A Medical Group, Inc.'s NPI number?

The NPI number for East Bay Retina Consultants A Medical Group, Inc. is 1124319959. It was assigned to this organization in the NPPES registry on April 27, 2011. The provider is doing business as East Bay Retina Consultants, Inc..

Where is East Bay Retina Consultants A Medical Group, Inc. located?

East Bay Retina Consultants A Medical Group, Inc. is located at 1401 Willow Pass Rd Suite 120, Concord, CA 94520. The listed phone number is (925) 680-1600.

What is East Bay Retina Consultants A Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is East Bay Retina Consultants A Medical Group, Inc. enrolled in Medicare?

Yes. East Bay Retina Consultants A Medical Group, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Bay Retina Consultants A Medical Group, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Ophthalmology, reassign their Medicare billing to East Bay Retina Consultants A Medical Group, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does East Bay Retina Consultants A Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1071572) is associated with this NPI, valid through July 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Bay Retina Consultants A Medical Group, Inc. was last updated on February 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.