Stephanie Joo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 15006 TLG Issued in CA

Practice address

1035 S de Anza Blvd Ste 1
San Jose, CA 95129-2772

Phone

(408) 446-5533

NPI assigned

Jul 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• De Anza Vision Center a Professional Optometric Corp

  • Optometrist
  • San Jose, CA
  • NPI 1760507784
  Medicare reassignment NPD Authorized official
• Vision Dynamics Optometric Center

  • Optometrist
  • Danville, CA
  • NPI 1023378635
  Medicare reassignment NPD

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1114335429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 S DE ANZA BLVD STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951292772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 S DE ANZA BLVD STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951292772",
            "telephone_number": "408-446-5533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950512901",
            "country_code": "US",
            "telephone_number": "408-984-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOO",
        "first_name": "STEPHANIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 15006 TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Jones, MPT, ATC
• Virginia L Jones
• Wallace Jones Jr., MD
• Wendell Rashad Jones
• Aileen C. Jong, L.AC.
• Andrea Jordan, PMHNP
• Caroline Denison Jordan
• David Jordan, MFTI
• Melanie Lynn Jordan, CNM
• Patricia J Jordan, MFT

• Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.

Verify at the official NPI Registry.