Organization Active NPI

Jennifer Quirante Professional Optometry Corp

  • Optometrist
  • Pacifica, CA
National Provider Identifier
1003902842
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JENNIFER QUIRANTE PROFESSIONAL OPTOMETRY CORP
Practice address
769 Hickey Blvd
Pacifica, CA 94044-1214
Phone
(650) 738-2205
Fax
(650) 738-2203
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Dr. Jennifer Quirante, ODNPI 1316917735
Title
Ceo
Phone
(650) 738-2205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

769 Hickey Blvd
Pacifica, CA 94044-1214

Mailing address

769 Hickey Blvd
Pacifica, CA 94044-1214
Phone (650) 738-2205

Other names 1

  • ROCKAWAY BEACH OPTOMETRY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041021000901 CA Part B Supplier - Clinic/Group Practice 8921069097 Receives reassigned benefits from 5 practitioners
Practice locations: Pacifica, CA

National Provider Directory

National Provider Directory

Locations

1335 Linda Mar Shopping Ctr
Pacifica, CA 94044
Phone (650) 738-2205

769 Hickey Blvd
Pacifica, CA 94044
Phone (650) 738-2205

225 Rockaway Beach Ave
Ste 2
Pacifica, CA 94044
Phone (650) 738-2205

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1003902842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 HICKEY BLVD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940441214",
            "telephone_number": "650-738-2205",
            "fax_number": "650-738-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 HICKEY BLVD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940441214",
            "telephone_number": "650-738-2205",
            "fax_number": "650-738-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER QUIRANTE PROFESSIONAL OPTOMETRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "QUIRANTE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-738-2205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROCKAWAY BEACH OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ROCKAWAY BEACH OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pacifica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.