NPIMap

Individual provider Active NPI

Jessie Y Hwang, O.D.

  • Optometrist
  • Menlo Park, CA
National Provider Identifier
1083766810
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT11151TPA Issued in CA
Practice address
795 Willow Rd BLDG 334
Menlo Park, CA 94025-2539
Phone
(650) 599-3899
Fax
(650) 321-5163
NPI assigned
Jan 18, 2007
Last updated
Mar 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT11151TPA CA Primary

Addresses

Primary practice location

795 Willow Rd BLDG 334
Menlo Park, CA 94025-2539

Mailing address

2124 Reinert CT
Mountain View, CA 94043-2354
Phone (650) 969-6768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070905000653 CA Practitioner - Optometry 1355434432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT11151TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

2710 Middlefield Rd
Redwood City, CA 94063
Phone (650) 364-6010

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

222 W 39th Ave
#316
San Mateo, CA 94403
Phone (415) 573-2222

306 Spruce Ave
South San Francisco, CA 94080
Phone (650) 589-9305

795 Willow Rd
Bldg 334
West Menlo Park, CA 94025
Phone (650) 599-3890

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1083766810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 REINERT CT",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940432354",
            "telephone_number": "650-969-6768",
            "fax_number": "650-969-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WILLOW RD BLDG 334",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252539",
            "telephone_number": "650-599-3899",
            "fax_number": "650-321-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "JESSIE",
        "middle_name": "Y",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT11151TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.