Individual provider Active NPI

Veronique Hedwige Jotterand, M.D.

  • Ophthalmology Physician
  • Long Beach, CA
National Provider Identifier
1083636187
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G54415 Issued in CA
Practice address
2865 Atlantic Ave
Suite 109
Long Beach, CA 90806-1740
Phone
(562) 988-2020
Fax
(562) 426-7394
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G54415 CA Primary

Addresses

Primary practice location

2865 Atlantic Ave
Suite 109
Long Beach, CA 90806-1740

Mailing address

2865 Atlantic Ave
Suite 109
Long Beach, CA 90806-1740
Phone (562) 988-2020

Other identifiers 1

IdentifierTypeStateIssuer
00G544150OtherCAMEDICAL PPIN #

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071018000313 CA Practitioner - Ophthalmology 9638265952 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54415CAMDOphthalmology Physician
54415CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Group Inc Past Accepting new patients
Healthcare Partners Affiliates Medical Group Ophthalmology PastSince Feb 11, 2016 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1083636187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 ATLANTIC AVE",
            "address_2": "SUITE 109",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061740",
            "telephone_number": "562-988-2020",
            "fax_number": "562-426-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 ATLANTIC AVE",
            "address_2": "SUITE 109",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061740",
            "telephone_number": "562-988-2020",
            "fax_number": "562-426-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOTTERAND",
        "first_name": "VERONIQUE",
        "middle_name": "HEDWIGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G54415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PPIN #",
            "identifier": "00G544150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.