Individual provider Active NPI

Jenna Therese Belardinelli, OD

  • Optometrist
  • Fresno, CA
National Provider Identifier
1114548153
Registry record updated May 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34527 Issued in CA
Practice address
5110 N Blackstone Ave
Fresno, CA 93710-6708
Phone
(559) 221-8900
NPI assigned
Apr 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34527 CA Primary

Addresses

Primary practice location

5110 N Blackstone Ave
Fresno, CA 93710-6708

Mailing address

5110 N Blackstone Ave Ste 108
Fresno, CA 93710-6708
Phone (559) 221-8900

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200911000835 CA Practitioner - Optometry 9032537790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
20/20 Optometric Thomas Casagrande ODGroup PAC ID 0941270292, 2 clinicians

Practice addresses (Care Compare)

5110 N Blackstone Ave
Suite 108
Fresno, CA 93710-6708
Phone (559) 221-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34527CAMDChiropractor

Organizations & group practices 1

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": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1114548153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 N BLACKSTONE AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106708",
            "telephone_number": "559-221-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106708",
            "telephone_number": "559-221-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELARDINELLI",
        "first_name": "JENNA",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.