Individual provider Active NPI

Jennifer Jiayun Zhang Yoo, OD

  • Vision Therapy Optometrist
  • Newport Beach, CA
National Provider Identifier
1164095220
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
35139TLG Issued in CA
Practice address
901 Dover Dr Ste 100
Newport Beach, CA 92660-5514
Phone
(949) 642-0292
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 35139TLG CA Primary
Optometrist 152W00000X 35139TLG CA

Addresses

Primary practice location

901 Dover Dr Ste 100
Newport Beach, CA 92660-5514

Mailing address

901 Dover Dr Ste 100
Newport Beach, CA 92660-5514
Phone (949) 642-0292

Other practice location 1

14929 Shady Grove Rd Unit K
Rockville, MD 20850-7728
Phone (301) 424-1050

Other names 1

  • Dr. Jennifer Jiayun Zhang Former name

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
I20240917004843 CA Practitioner - Optometry 9234526450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35139CAMDGeneral Practice Dentistry
35139TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Appelbaum Eyecare Associates Vision Therapy PastSince Jul 1, 2021 Accepting new patients

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1164095220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 DOVER DR STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605514",
            "telephone_number": "949-642-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOVER DR STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605514",
            "telephone_number": "949-642-0292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14929 Shady Grove Rd Unit K",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208507728",
            "country_code": "US",
            "telephone_number": "301-424-1050",
            "fax_number": "301-424-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHANG YOO",
        "first_name": "JENNIFER",
        "middle_name": "JIAYUN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "35139TLG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35139TLG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ZHANG",
            "middle_name": "JIAYUN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.