Active NPI
Joanne C. Gwo, O.D.
- Optometrist
- South San Francisco, CA
National Provider Identifier
1083900336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT14201TLG
- Practice address
- 1600 El Camino Real
Optometry Department
South San Francisco, CA 94080-1206 - Phone
- (650) 992-5881
- NPI assigned
- Jun 24, 2011
- Last updated
- Aug 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT14201TLG | CA | Primary |
Addresses
Primary practice location
1600 El Camino Real
Optometry Department
South San Francisco, CA 94080-1206
Mailing address
2010 El Camino Real # 336
Santa Clara, CA 95050-4051
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT14201TLG | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crest Optometry, Inc | Optometrist | Current | Accepting new patients |
| Mark S Ichikawa, OD | Optometrist | Past | Accepting new patients |
| Cindy H. Tran, OD, a Professional Optometric Corporation | Optometrist | Past | Accepting new patients |
Locations
173 N Morrison Ave
Ste B
San Jose, CA 95126
Phone (408) 372-7647
173 N Morrison Ave
Ste E
San Jose, CA 95126
Phone (408) 372-7647
Interoperability endpoints
- joanne.gwo@49412312072196.direct.elationemr.com
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.
-
- Optometrist
- San Jose, CA
- NPI 1366739195
-
dba Sunnyvale Optometry
- Optometrist
- Sunnyvale, CA
- NPI 1730510165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1083900336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 EL CAMINO REAL # 336",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950504051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 EL CAMINO REAL",
"address_2": "OPTOMETRY DEPARTMENT",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940801206",
"telephone_number": "650-992-5881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWO",
"first_name": "JOANNE",
"middle_name": "C.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-24",
"last_updated": "2022-08-24",
"certification_date": "2022-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT14201TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.