PACIFIC EYE INSTITUTE A MEDICAL GROUP INC
NPI 1407932619
Clinic/Center - Ambulatory Surgical in Upland, CA

NPI Status: Active since October 31, 2006

Contact Information

555 N 13TH AVE
UPLAND, CA
ZIP 91786
Phone: (909) 982-8846
Fax: (909) 931-0791

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 05D2054597
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-24-2027

About PACIFIC EYE INSTITUTE A MEDICAL GROUP INC

This page provides the complete NPI Profile along with additional information for Pacific Eye Institute A Medical Group Inc, a provider established in Upland, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1407932619 assigned on October 2006. The practitioner's primary taxonomy code is 261QA1903X with license number 240000525 (CA). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Richmond Roeske (Physician/owner)

NPI
1407932619
Provider Legal Name
PACIFIC EYE INSTITUTE A MEDICAL GROUP INC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
555 N 13TH AVE UPLAND, CA 91786
Location Phone
(909) 982-8846
Location Fax
(909) 931-0791
Mailing Address
555 N 13TH AVE UPLAND, CA 91786
Mailing Phone
(909) 982-8846
Mailing Fax
(909) 931-0791
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-31-2006
Last Update Date
02-14-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
240000525
License State
CA

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RICHMOND ROESKE

Authorized Official Title
PHYSICIAN/OWNER
Authorized Official Phone
(800) 345-8979

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
SUR51061FMEDICAID (05)CA 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

This procedure involves removing a cloudy lens (cataract) from your eye through a larger incision, replacing it with an artificial one. A drainage device is also inserted in the front part of your eye to manage fluid levels, helping maintain eye health.

This service was performed 14 times for 13 patients

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 72 times for 57 patients

Complex repair of detached retina and drainage of eye fluid between lens and retina

This procedure involves reattaching your detached retina, a vital layer at the back of your eye. Simultaneously, excess fluid between your lens and retina is drained. This helps restore vision and prevent further eye damage.

This service was performed 15 times for 14 patients

Creation of eye fluid drainage tracts in iris using a laser, per session

This procedure uses a laser to create small drainage tracts in the iris, the colored part of your eye. This helps excess fluid escape, reducing pressure in the eye that can cause glaucoma. It's performed in sessions.

This service was performed 23 times for 16 patients

Dilation of fluid outflow drainage within eye

Dilation to improve eye fluid flow is a process where eye drops are used to widen or dilate your pupils. This allows more fluid to flow out of the eye, reducing pressure and helping to prevent or treat conditions like glaucoma.

This service was performed 97 times for 69 patients

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.

This service was performed 85 times for 59 patients

Laser repair to improve eye fluid flow

Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.

This service was performed 81 times for 55 patients

Processing, preserving and transporting corneal tissue

Processing, preserving, and transporting corneal tissue involve careful steps to ensure its viability for transplantation. The tissue is first cleaned, then preserved in a special solution. It's packed in a temperature-controlled container for safe transport to its destination.

This service was performed 13 times for 13 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 704 times for 458 patients

Removal of excessive skin and fat of upper eyelid

This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.

This service was performed 58 times for 29 patients

Removal of growth of cornea

The removal of a corneal growth is a procedure to eliminate abnormal tissue from the cornea, the clear front surface of the eye. This can help improve vision and alleviate discomfort. The process is typically performed by an ophthalmologist under local anesthesia.

This service was performed 19 times for 15 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 398 times for 291 patients

Removal or relocation of corneal conjunctiva with graft

This procedure involves the removal or relocation of the conjunctiva, a thin layer covering the white part of your eye, and replacing it with a graft. This is typically done to treat conditions affecting the eye's surface, improving comfort and vision.

This service was performed 29 times for 23 patients

Repair of detached retina with drainage and removal of eye fluid between lens and retina

This procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.

This service was performed 13 times for 13 patients

Shortening or advancement of upper eyelid muscle to correct drooping or paralysis

This procedure involves adjusting the muscle in your upper eyelid to correct drooping or paralysis. The muscle may be shortened or advanced to help lift the eyelid to a better position. This can improve vision and give a more alert appearance. It's typically an outpatient procedure.

This service was performed 20 times for 13 patients

Transplantation of outer layer of corneal tissue

The transplantation of the outer layer of corneal tissue is a procedure to replace damaged or diseased corneal tissue with healthy tissue from a donor. This can improve vision and alleviate pain or discomfort.

This service was performed 14 times for 14 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2054597
Facility Type
Physician Office
Certificate Effective Date
February 25, 2025
Certificate Expiration Date
February 24, 2027
Laboratory Director
JESSE A. DOVICH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pacific Eye Institute A Medical Group Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1407932619, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
0
Doubled → 0
Pos 4
7
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
2
Doubled → 4
Pos 8
6
Unchanged
Pos 9
1
Doubled → 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 0 + 7 + 1 + 8 + 3 + 4 + 6 + 2 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1407932619.

Other Providers at the Same Location


The following 17 providers are registered at the same or a nearby location.

Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Anesthesiology
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Optometrist
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology (Retina Specialist)
555 N 13TH AVE
UPLAND, CA 91786
Optometrist
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology (Retina Specialist)
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Optometrist
555 N 13TH AVE
UPLAND, CA 91786
Optometrist
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology (Retina Specialist)
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786
Ophthalmology
555 N 13TH AVE
UPLAND, CA 91786

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407932619, enumerated as an "organization" on October 31, 2006.

The provider is located at 555 N 13TH AVE UPLAND, CA 91786 and the phone number is (909) 982-8846.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.