Individual provider Active NPI

Mark Allen Jones, O.D.

  • Optometrist
  • Lafayette, CA
National Provider Identifier
1073639001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9438T Issued in CA
Practice address
105 Villa CT
Lafayette, CA 94549-2017
Phone
(925) 935-4635
NPI assigned
Mar 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9438T CA Primary

Addresses

Primary practice location

105 Villa CT
Lafayette, CA 94549-2017

Mailing address

105 Villa CT
Lafayette, CA 94549-2017
Phone (925) 935-4635

Other identifiers 1

IdentifierTypeStateIssuer
SD0094380MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9438TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vallejo Optometry Group Optometrist Past Accepting new patients
Luxottica of America Inc Past Accepting new patients
Walnut Creek Optometry Group Optometrist PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073639001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VILLA CT",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945492017",
            "telephone_number": "925-935-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VILLA CT",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945492017",
            "telephone_number": "925-935-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9438T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0094380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.