Individual provider Active NPI

Jane Yoo, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1114573946
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003583 Issued in PA
Practice address
1030 Arch St
Philadelphia, PA 19107-3011
Phone
(215) 238-1444
NPI assigned
Aug 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 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 OEG003583 PA Primary

Addresses

Primary practice location

1030 Arch St
Philadelphia, PA 19107-3011

Mailing address

10 Farm Way
Harleysville, PA 19438-2983
Phone (267) 736-7940

Other practice location 1

1111 E End Blvd
Wilkes Barre, PA 18711-0030
Phone (570) 824-3521 ext. 27507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191223001077 PA Practitioner - Optometry 9133553381 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003583PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
City Line Eye Care LLC Optometrist CurrentSince Feb 1, 2022 Accepting new patients
Cohen Fashion Optical, LLC PastSince May 12, 2024 Accepting new patients

Locations

49 E City Ave
#10
Bala Cynwyd, PA 19004
Phone (610) 206-3866

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1114573946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FARM WAY",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382983",
            "telephone_number": "267-736-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 ARCH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073011",
            "telephone_number": "215-238-1444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 E End Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187110030",
            "country_code": "US",
            "telephone_number": "570-824-3521 x27507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOO",
        "first_name": "JANE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.