Individual provider Active NPI

John C Coen, O.D.

  • Optometrist
  • Rocklin, CA
National Provider Identifier
1174615793
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9390 Issued in CA
Practice address
6809 Five Star Blvd
Suite 101a
Rocklin, CA 95677-2687
Phone
(916) 624-2020
Fax
(916) 624-3027
NPI assigned
Sep 29, 2006
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9390 CA Primary

Addresses

Primary practice location

6809 Five Star Blvd
Suite 101a
Rocklin, CA 95677-2687

Mailing address

6809 Five Star Blvd
Suite 101a
Rocklin, CA 95677-2687
Phone (916) 624-2020

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
I20041110001291 CA Practitioner - Optometry 2567431778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6809 Five Star Blvd
Suite 100a
Rocklin, CA 95677-2687
Phone (916) 624-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Center Optometrics, a Professional Corporation Optometrist CurrentSince Mar 1, 2000 Accepting new patients
Eye Center Optometrics, a Professional Corporation Optometrist CurrentSince Mar 1, 2000 Accepting new patients
Eye Center Optometrics, a Professional Corporation Optometrist Past Accepting new patients
Eyecenter Optometrics, a Professional Corporation Optometrist Past Accepting new patients

Locations

5959 Greenback Ln
Ste 130
Citrus Hts, CA 95621
Phone (916) 726-1818

421 Blue Ravine Rd
Ste 300
Folsom, CA 95630
Phone (916) 452-4706

2200 Sunrise Blvd
Ste 120
Gold River, CA 95670
Phone (916) 852-1600

6809 Five Star Blvd
Ste 100A
Rocklin, CA 95677
Phone (916) 624-2020

2831 J St
Sacramento, CA 95816
Phone (916) 441-5800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1174615793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 FIVE STAR BLVD",
            "address_2": "SUITE 101A",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772687",
            "telephone_number": "916-624-2020",
            "fax_number": "916-624-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 FIVE STAR BLVD",
            "address_2": "SUITE 101A",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772687",
            "telephone_number": "916-624-2020",
            "fax_number": "916-624-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COEN",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

Verify at the official NPI Registry.