Julie Ann Wagstaff, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11444 Issued in CA

Practice address

2200 Eastridge Loop
Eastridge Mall Ste 1078
San Jose, CA 95122-1410

Phone

(408) 270-6161

Fax

(408) 270-6176

NPI assigned

Jan 16, 2007

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

Specialty

Optometry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mina Chen OD CorpGroup PAC ID 2264824994, 2 clinicians

Sonoma Eyeworks an Optometric CorporationGroup PAC ID 4082043963, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mina Chen OD Corp

  • Optometrist
  • Petaluma, CA
  • NPI 1942881180
  Medicare reassignment Care Compare group NPD
• Sonoma Eyeworks an Optometric Corporation

  • Optometrist
  • Santa Rosa, CA
  • NPI 1891330171
  Medicare reassignment Care Compare group NPD
• J Michael Harmon OD an Optometric Corporation

  • Optometrist
  • Santa Rosa, CA
  • NPI 1003263070
  NPD
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124179908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 SPENCER AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951251672",
            "telephone_number": "408-947-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 EASTRIDGE LOOP",
            "address_2": "EASTRIDGE MALL STE 1078",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221410",
            "telephone_number": "408-270-6161",
            "fax_number": "408-270-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSTAFF",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Wagner, L.M.F.T.
• Caroline Silva Wagner
• David A Wagner
• Erik Wagner
• Gwendolyne Marie Wagner
• Kathryn J Wahl, RD
• Leonardo Wai
• Janine Ann Waitzman-Yi, PHD
• Ruta V Wakharkar, MD
• Wal-Mart Stores Inc

• 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 Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.