Individual provider Active NPI

Joseph Albert Giovannini, M.D.

  • Ophthalmology Physician
  • Travis Afb, CA
National Provider Identifier
1083679542
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G74188 Issued in CA
Practice address
101 Bodin Cir
Travis Afb, CA 94535
Phone
(707) 423-7165
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cornea and External Diseases Specialist Physician 207WX0120X ME166337 FL
Ophthalmology Physician 207W00000X G74188 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Travis Afb, CA 94535

Mailing address

101 Bodin Cir
Travis Afb, CA 94535-1809
Phone (707) 423-7165

Other practice location 1

9904 Palatte CT
Clinton, MD 20735-5824
Phone (925) 200-0323

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
I20180808003684 CA Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 1355584103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G74188CAMDOphthalmology Physician
ME166337FLMDCornea and External Diseases Specialist Physician

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1083679542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "707-423-7165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9904 PALATTE CT",
            "address_purpose": "LOCATION",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207355824",
            "country_code": "US",
            "telephone_number": "925-200-0323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIOVANNINI",
        "first_name": "JOSEPH",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "FL",
            "license": "ME166337",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G74188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.