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

Active since October 31, 2006CLIA Certified · 2 labs
555 N 13TH AVE, UPLAND, CA 91786(909) 982-8846(909) 931-0791 Get Directions Write a Review

NPPES record last updated: February 14, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 05D1003463
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 08-29-2026

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 authorized official of this NPI record is Richmond Roeske (Physician/owner)

NPI
1407932619
Provider Name
PACIFIC EYE INSTITUTE A MEDICAL GROUP INC
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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Location Map

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 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 77 times for 67 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 26 times for 17 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 69 times for 49 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 75 times for 56 patients

Incision to improve eye fluid flow

This procedure, known as a trabeculectomy, involves creating a small opening in the eye to improve fluid flow. This can help lower eye pressure in conditions like glaucoma. It's a common, safe procedure to protect your eye health.

This service was performed 21 times for 17 patients

Injection, dexamethasone, intravitreal implant, 0.1 mg

This procedure involves placing a tiny implant into your eye. This implant slowly releases a medication called dexamethasone, which helps to reduce inflammation and swelling in the eye, improving vision and comfort.

This service was performed 24 times for 23 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 80 times for 51 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 620 times for 419 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 26 times for 13 patients

Removal of membrane of retina with removal of internal limiting membrane of retina

This procedure involves the surgical removal of a thin layer, called the membrane, from the retina. It also includes the removal of the innermost layer of the retina, known as the internal limiting membrane. This can help improve vision.

This service was performed 13 times for 13 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 419 times for 282 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 23 times for 17 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 18 times for 15 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
05D1003463
Facility Type
Community Clinic
Certificate Effective Date
August 30, 2024
Certificate Expiration Date
August 29, 2026
Laboratory Director
ROBERT N. FABRICANT MD
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 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.