Craig Jensen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9552945-9934 Issued in UT

Practice address

338 S Dakota Ave
Vandenberg Afb, CA 93437-6307

Phone

(805) 606-7962

NPI assigned

Oct 15, 2015

Sex

Male

Sole proprietor

Yes

Specialty

Optometry

Education

International American University at Puerto Rico - School of Optometry, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in UT

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

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

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1164893202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 S DAKOTA AVE",
            "city": "VANDENBERG AFB",
            "state": "CA",
            "postal_code": "934376307",
            "telephone_number": "805-606-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 S DAKOTA AVE",
            "city": "VANDENBERG AFB",
            "state": "CA",
            "postal_code": "934376307",
            "telephone_number": "805-606-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100487",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "9552945-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alecia Hagman, DO
• Jennifer H Harris, PSY.D.
• Health and Wellness Center
• Daniel Anthony Jacobson
• William Francis Jennings, DMD
• Wanda Ivette Jimenez
• Melissa E Jordan
• Roxanne Keeney, RN
• David Bruce Kieser, D.D.S.
• Arthur Dwayne Kisby, PHARMD

• All providers in Vandenberg Afb, CA
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.