Nova Eye Care Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

3500 Issued in WA

Legal business name

NOVA EYE CARE INC

Practice address

17410 Highway 99
Suite 110
Lynnwood, WA 98037-3632

Phone

(425) 742-3777

Fax

(425) 742-8695

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steven W Jang, O.D.NPI 1669420097

Title

President

Phone

(425) 742-3777

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nova Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Wangsoo Jang, O.D.

  • Optometrist
  • Lynnwood, WA
  • NPI 1669420097
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408752000000",
    "number": "1174652952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17410 HIGHWAY 99",
            "address_2": "SUITE 110",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373632",
            "telephone_number": "425-742-3777",
            "fax_number": "425-742-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17410 HIGHWAY 99",
            "address_2": "SUITE 110",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373632",
            "telephone_number": "425-742-3777",
            "fax_number": "425-742-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA EYE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2014-08-23",
        "status": "A",
        "authorized_official_last_name": "JANG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-742-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2032191",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "100000125710",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nova Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.