NPIMap

Organization Active NPI

Arrowhead Eye Associates Inc

  • Ophthalmology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1013466093
Registry record updated Oct 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
11065 Issued in CA
Legal business name
ARROWHEAD EYE ASSOCIATES INC
Practice address
10837 Laurel St
Suite 103
Rancho Cucamonga, CA 91730-7643
Phone
(530) 755-7118
NPI assigned
Oct 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2016

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

Authorized official

Name
Jaskarn Johl, MDNPI 1245492677
Title
MD/Owner
Phone
(530) 755-7118

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 11065 CA Primary

Addresses

Primary practice location

10837 Laurel St
Suite 103
Rancho Cucamonga, CA 91730-7643

Mailing address

10837 Laurel St
Suite 103
Rancho Cucamonga, CA 91730-7643
Phone (530) 755-7118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161107000697 CA Part B Supplier - Clinic/Group Practice 0345528717 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Ontario, CA; Rancho Cucamonga, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Arrowhead Eye Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: jjohl@arrow.intellechartdirect.net
  • Direct secure messaging: ashah@arrow.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 4

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": "1475280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475280000000",
    "number": "1013466093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10837 LAUREL ST",
            "address_2": "SUITE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307643",
            "telephone_number": "530-755-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10837 LAUREL ST",
            "address_2": "SUITE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307643",
            "telephone_number": "530-755-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROWHEAD EYE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-01",
        "last_updated": "2016-10-01",
        "status": "A",
        "authorized_official_last_name": "JOHL",
        "authorized_official_first_name": "JASKARN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "530-755-7118",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "11065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; 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.