Individual provider Active NPI

Jamie Starr Peters, O.D.

  • Optometrist
  • La Mesa, CA
National Provider Identifier
1073691077
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10724T Issued in CA
Practice address
8235 University Ave
La Mesa, CA 91942-9320
Phone
(619) 461-4913
Fax
(619) 465-5070
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10724T CA Primary

Addresses

Primary practice location

8235 University Ave
La Mesa, CA 91942-9320

Mailing address

8235 University Ave
La Mesa, CA 91942-9320
Phone (619) 461-4913

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050107000799 CA Practitioner - Optometry 1557319332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Solutions Optometry IncGroup PAC ID 5890021232, 2 clinicians

Practice addresses (Care Compare)

8235 University Ave
La Mesa, CA 91942-9326
Phone (619) 461-4913

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10724TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2010 Accepting new patients
Vision Solutions Optometry, Inc. Optometrist CurrentSince Mar 15, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Dr Caroline G Cauchi, O.D., Inc Optometrist CurrentSince Apr 1, 2019 Accepting new patients

Locations

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1073691077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 UNIVERSITY AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919429320",
            "telephone_number": "619-461-4913",
            "fax_number": "619-465-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8235 UNIVERSITY AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919429320",
            "telephone_number": "619-461-4913",
            "fax_number": "619-465-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JAMIE",
        "middle_name": "STARR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10724T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.